What are the other Names for this Condition? (Also known as/Synonyms)

• Dermatosis Neglecta
• DN (Dermatitis Neglecta)

What is Dermatitis Neglecta? (Definition/Background Information)

• Dermatitis Neglecta (DN) is described as a skin disorder that develops from long-term poor hygiene. Individuals with this disorder neglect keeping their skin clean either unconsciously or intentionally
• This results in dark pigmented skin lesions due to accumulation of oil and dirt, which are usually asymptomatic anywhere on the body, typically on the chest, back, and genitals. No other significant symptoms or complications are generally noted
• Dermatitis Neglecta is generally treated through frictional washing (such as through use of scrubbers) of the affected skin with soap and water. The outcomes are typically excellent following suitable management of the condition

Who gets Dermatitis Neglecta? (Age and Sex Distribution)

• Even though only a few cases are known to be recorded in the medical literature, it is believed that Dermatitis Neglecta is common and mostly goes underreported
• Dermatitis Neglecta is observed in individuals of all age groups
• Both males and females are affected
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Dermatitis Neglecta? (Predisposing Factors)

The risk factors for Dermatitis Neglecta include:

• Individuals with mental health disorders
• Individuals with certain physical disabilities
• Individuals in severe pain or emotional stress
• Surgical sites that may cause pain or fear; some individuals may be afraid of cleaning post-surgical (suture) wounds for fear of rupturing them
• Individuals without access to basic amenities such as clean water to bathe
• Some individuals are more prone to Dermatitis Neglecta due to sensitive skins

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Dermatitis Neglecta? (Etiology)

• Dermatitis Neglecta is caused from a lack of cleanliness i.e., not washing a certain body region or bathing for many months
• This results in poor exfoliation of skin (shedding of materials, dead cells, etc.) causing sweat, sebum (oil), dead skin cells, skin flora (microbiota), and dirt to collect in the form of thick patches on skin

What are the Signs and Symptoms of Dermatitis Neglecta?

The signs and symptoms of Dermatitis Neglecta may include:

• Presence of scaly skin in patches
• Dark spots on skin (areas of hyperpigmentation)
• The patches may be localized or widespread, developing over 2-4 months
• The skin lesions are commonly noted on the trunk, limbs, face, and genitalia
• Some surgical sites may also present these lesions of neglect

How is Dermatitis Neglecta Diagnosed?

An early recognition of the condition can help avoid unnecessary and expensive diagnostic procedures and treatment measures. A diagnosis of Dermatitis Neglecta may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation; in many cases, a visual exam may be conclusive
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A skin biopsy is usually not necessary to diagnose Dermatitis Neglecta

A differential diagnosis is important to exclude diseases/conditions that present similar signs and symptoms. These may include:

• Acanthosis nigricans
• Atopic dermatitis
• Confluent and reticulated papillomatosis
• Dermatitis artefacta
• Pityriasis versicolor
• Psoriasis
• Seborrheic dermatitis
• Terra firma-forme dermatosis (Duncan's dirty dermatosis) - it is the most important differential diagnosis for Dermatitis Neglecta
• Verrucous epidermal naevus

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Dermatitis Neglecta?

The possible complications due to Dermatitis Neglecta include:

• Emotional stress due to cosmetic issues
• Superimposed bacterial and fungal skin infections
• Scrubbing the lesions too hard may result in oozing discharge or bleeding

How is Dermatitis Neglecta Treated?

The treatment measures available for Dermatitis Neglecta include:

• Washing the involved skin region with recommended soap and water (or isopropyl alcohol), and using a mild scrubber, for a few weeks to months
• Application of keratolytic agents, such as salicylic acid, for more severe cases

How can Dermatitis Neglecta be Prevented?

Dermatitis Neglecta may be prevented by considering the following steps:

• Regular bathing with scrubbing of skin (at least twice a week)
• Using suitable body wash cleansers
• Instructing caregivers on how to maintain cleanliness and hygiene in the patients they care for
• Individuals with surgical scars and wounds may be informed about how to care for them, including the importance of keeping them regularly clean
• Small children must be given regular baths

What is the Prognosis of Dermatitis Neglecta? (Outcomes/Resolutions)

• The prognosis of Dermatitis Neglecta is generally excellent with proper management of the condition
• Even though it may take a few weeks/months for the skin to return to normal, adhering to good hygiene practices and regular cleaning of skin (using soap and water) can prevent any recurrences

Additional and Relevant Useful Information for Dermatitis Neglecta:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/