Table of ContentsView AllTable of ContentsCausesSymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
Diagnosis
Treatment
Dermatitis neglecta can usually be diagnosed based on a physical exam and a review of your medical history. Less commonly, a skin biopsy may be performed to rule out mimicking conditions.
Treatment involves daily light scrubbing with soap and water or isopropyl alcohol. In severe cases, a topical agent like salicylic acid may be used to remove the scales.
This article describes the causes and symptoms of dermatitis neglecta and explains how this uncommon skin condition is diagnosed and treated.
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What Causes Dermatitis Neglecta?
When the skin is not properly scrubbed, the outermost layer of the skin called thestratum corneumis not exfoliated of skin cells calledcorneocytes.
Over time, these corneocytes (from the Latin meaning “scales”) will start to accumulate and get stuck together with body oils and sweat. Bacteria normally found on the skin will then start to proliferate, causing the unshed cells to turn dark and smelly.
Certain people are at higher risk of dermatitis neglecta, including:
Misinformation is another possible culprit. In one published case, a person was instructed not to wash their face with a washcloth after a facial peel. Prolonged avoidance led to the development of brown scales which the individual presumed was a reaction to the peel.
What Are the Symptoms of Dermatitis Neglecta?
While otherwise painless, dermatitis neglecta can be physically unappealing. Symptoms include:
Interestingly, dermatitis neglecta is often without itch, and the surrounding skin may not have the discoloration (a change in skin tone) or redness (erythema) characteristic of otherforms of dermatitis.
Although dermatitis neglecta is rarely life-threatening, this shouldn’t suggest that it is entirely harmless. People with dermatitis neglecta will often pick at the scales, causing pain, bleeding, and oozing. This can introduce bacteria into underlying tissues, causing asecondary skin infectionthat can become serious if left untreated.
How Dermatitis Neglecta Is Diagnosed
A review of your medical history and a skin examination are usually sufficient to diagnose dermatitis neglecta. During the exam, the healthcare provider may swab the skin with alcohol to clear the scales and reveal normal skin underneath. This, along with an assessment of personal hygiene, is usually enough to confirm the diagnosis.
If there is any doubt, the provider may order additional tests to rule out other possible causes, such as:
This may involve an in-office test called aKOH testused to diagnose fungal skin infection. Askin biopsycan be used to check for cell abnormalities associated with eczema, warts, or acanthosis nigricans.
The treatment of dermatitis neglecta is straightforward and consists of daily light scrubbing of the affected area with soap and water or isopropyl alcohol (rubbing alcohol). Isopropyl alcohol is generally intended for short-term treatment as the overuse can lead to skin rash, itching, dryness, and redness.
For severe cases, akeratolytic agentmay be recommended. These are topical agents that dissolve dried scales and gently exfoliate the skin. Options include:
Anemollient moisturizercan also help soften plaques and lock in moisture after treatment.
Summary
5 Sources
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Saha A, Seth J, Sharma A, Biswas D.Dermatitis neglecta—a dirty dermatosis: report of three cases.Indian J Dermatol. 2015;60(2):185-187. doi:10.4103/0019-5154.152525
Lopes S, Vide J, Antunes I, Azevedo F.Dermatitis neglecta: a challenging diagnosis in psychodermatology.Acta Dermatovenerol Alp Pannonica Adriat. 2018;27(2):109-110.
Palaniappan V, Sadhasivamohan A, Kaliaperumal K.Dermatosis neglecta: a retrospective study at a tertiary care center in Southern India.Indian J Dermatol..2023 Nov-Dec;68(6):628–633. doi:10.4103/ijd.ijd_705_22
Langar S, Sonthalia S.Dermatitis neglecta.Indian J Med Res. 2018;147(3):322. doi:10.4103/ijmr.IJMR_43_17Perez-Rodriguez IM, Munoz-Garza FZ, Ocampo-candiani J.An unusually severe case of dermatosis neglecta: a diagnostic challenge.Case Rep Dermatol. 2014;6(2):194-199. doi:10.1159/000366515
Langar S, Sonthalia S.Dermatitis neglecta.Indian J Med Res. 2018;147(3):322. doi:10.4103/ijmr.IJMR_43_17
Perez-Rodriguez IM, Munoz-Garza FZ, Ocampo-candiani J.An unusually severe case of dermatosis neglecta: a diagnostic challenge.Case Rep Dermatol. 2014;6(2):194-199. doi:10.1159/000366515
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