Bilateral nipple neoformations

Case report: Dermatosis neglecta mimicking pemphigus foliaceus in association with obsessive-compulsive disorder

Dermatosis neglecta (DN) is a frequently underrecognized skin disorder that occurs due to unconscious or conscious neglect of self-cleaning, causing the accumulation of keratin, sweat, sebum, and impurities. It is characterized by asymptomatic yellowish-to-brownish, waxy, adherent papules or plaques with cornflake-like scales that mimic several dermatological conditions. DN awareness is crucial for avoiding unnecessary invasive diagnostic procedures. Its lesions can be removed with some difficulty by ordinary cleansing and efficiently cleared with ethyl or isopropyl alcohol. Individuals with underlying physical or mental disabilities or psychiatric conditions are highly associated with DN. Nevertheless, supportive evidence for the coexistence of DN and psychological conditions is sparse, and most individuals with mental problems usually deny having psychiatric issues. Here, we present a case of DN resembling pemphigus foliaceus on the face with obsessive-compulsive disorder in a 16-years old male. The definitive diagnosis of DN in this patient was confirmed via histopathological examination. The lesions completely disappeared after appropriate facial cleansing and psychiatric management. DN may reveal underlying psychiatric disorders in patients.

Dermatosis neglecta

Dermatosis neglecta (DN) is often an under diagnosed and reported dermatological entity which occurs due to unconscious neglect of self-cleaning in individuals with some underlying physical or mental pathology. It leads to accumulation of scales, dirt, sweat and sebum compacted together in the skin. Owing to its asymptomatic nature, diverse background and deceptive clinical presentation, it is often missed by the physicians. Awareness and recognition of this condition is necessary to avoid unnecessary diagnostic and treatment procedures. The focus of our review article is to provide insights into these often under diagnosed and reported entity. Also, we intend to develop an algorithm for practical approach to a clinical diagnosis of dirt-like dermatosis of skin with reasonable accuracy. A few interesting cases of DN encountered in our institution are included in this article.