Dermatitis Neglecta: What Causes It and How to Prevent It

Medically Reviewed By Amanda Caldwell, MSN, APRN-C
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Dermatitis neglecta occurs when dirt and dead skin cells build up on the skin. Primary symptoms include hyperpigmented patches and scaly skin. Doctors often diagnose the condition by looking at the clinical symptoms. They may also ask you about your full medical history. Treatments include regular washing and keratolytic agents.

This article will explain the symptoms and causes of dermatitis neglecta. It will also discuss the diagnosis and treatment for the condition.

What is dermatitis neglecta?

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Dermatitis neglecta is a skin condition that causes scaly, hyperpigmented patches to form on the skin.

Your skin constantly produces new skin cells and sheds old ones. At the same time, germs, oils, and sweat always build up on your skin.

If you do not wash sufficiently to eliminate these substances, they may merge and form lesions, according to 2022 research.

According to experts, dermatitis neglecta can occur in people of all ages and with all skin types. That said, it mainly develops in people who have:

  • a physical or mental disability
  • a sensory disturbance
  • pain or trauma in the affected area
  • had surgery in the affected area

Another name for dermatitis neglecta is dermatosis neglecta.

Read more about dermatitis.

What are symptoms of dermatitis neglecta?

Dermatitis neglecta can appear as hyperpigmented patches which are scaly and flaky.
Dermatitis neglecta can appear as hyperpigmented patches which are scaly and flaky.

Dermatitis neglecta lesions may form on:

  • your torso
  • your genitals
  • your limbs
  • your face
  • areas where you have had surgery

According to a 2015 report on three cases of dermatitis neglecta, the spots will typically have hyperpigmented patches and be scaly and flaky.

Yet many cases are asymptomatic, meaning people show no visible signs of the condition, so you might not even know you have dermatitis neglecta.

Other signs may include:

  • waxy, dark, and slightly raised patches 
  • sensitive skin
  • inflamed and irritated skin
  • scales that stick well to the skin

Symptoms may take up to 4 months to fully develop. 

Sometimes an infection can form within the lesions. This can cause a fever, worsening pain, and blisters that leak pus or fluid.

What causes dermatitis neglecta?

Experts do not know the precise reasons for dermatitis neglecta, according to the 2015 report mentioned earlier. Improper hygiene may play a role, 2022 research suggests.

This theory comes from the fact that the lesions always contain substances such as:

  • oils or sebum
  • sweat
  • keratin
  • bacteria
  • dead skin cells

A lack of cleaning may lead to improper exfoliation. This, in turn, may cause symptoms of dermatitis neglecta.

Dermatitis neglecta vs. other types of dermatitis

“Dermatitis” is an umbrella term for all kinds of conditions that cause skin inflammation.

Types may include:

The primary difference between dermatitis neglecta and other types of dermatitis is that the former is easily treatable and preventable with proper hygiene.

Terra firma-forme dermatosis vs. dermatitis neglecta 

Some people confuse dermatitis neglecta with terra firma-forme dermatosis. But the two conditions are different.

Terra firma-forme dermatosis is a benign, or noncancerous, condition in which brown-to-black lesions develop on the skin. It results from the atypical and delayed development of skin cells, experts say. 

How do you treat dermatitis neglecta?

The main remedy for dermatitis neglecta is daily washing, the aforementioned 2015 report suggests. Your doctor may advise you to wash the affected area with isopropyl alcohol or soapy water.

This will typically clear the lesions within a few days to a few months.

If your lesions fail to disappear, your doctor may recommend a keratolytic agent, such as salicylic or glycolic acid. A keratolytic agent breaks down the outer layer of skin, dissolving skin flakes and scales.

How is dermatitis neglecta diagnosed?

Although you can easily treat dermatitis neglecta with home remedies, it is important to have a dermatologist rule out other conditions first. 

Your dermatologist will look at the clinical signs to make a diagnosis. They may also take a full medical history.

If they are uncertain, your dermatologist may perform a skin biopsy. Dermatitis neglecta can often look like other skin conditions, so your dermatologist will take extra care to get the diagnosis right.

These conditions include:

What are risk factors for dermatitis neglecta? 

Some factors can increase your risk of dermatitis neglecta. They include:

  • Older age: Aging and age-related conditions can lead to a lack of proper self-care.
  • Trauma: Trauma may make some areas of the body hard to reach or clean.
  • Surgery: This can also prevent adequate washing due to pain or discomfort.
  • Physical disabilities and mental health conditions: These can also lead to a lack of proper self-care.
  • Sensitive skin: A person may avoid washing sensitive and easily irritated areas of the skin.

How can you prevent dermatitis neglecta?

Daily washing and rubbing of the skin can help prevent dermatitis neglecta.

Periodic exfoliation with a dry brush can also help. If you have undergone surgery and cannot perform regular frictional washing, consider hiring a caregiver, if possible. You could also ask relatives or friends to help. 

Remember to use fragrance-free cleansers for sensitive skin.

Summary

Dermatitis neglecta causes scaly, hyperpigmented patches to form on the skin. It commonly results from a lack of proper hygiene. 

Diagnosis is usually based on clinical signs. In some cases, however, a dermatologist may perform a biopsy

Risk factors for dermatitis neglecta include older age, trauma, and surgery. Other factors are sensitive skin and physical or mental disabilities.

The main treatment method for the condition is daily washing. Your dermatologist will advise you to wash the affected area with isopropyl alcohol or soapy water. They may also recommend a keratolytic agent, such as salicylic or glycolic acid, if you have lesions that do not go away.

You may want to report any concerning symptoms you have to your doctor for diagnosis and treatment.

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Medical Reviewer: Amanda Caldwell, MSN, APRN-C
Last Review Date: 2022 Sep 28
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  2. Coulson, I. (2022). Dermatitis. https://dermnetnz.org/topics/dermatitis
  3. Palaniappan, V., et al. (2022). Dermatosis neglecta. https://onlinelibrary.wiley.com/doi/abs/10.1111/ced.15184
  4. Saha, A., et al. (2015). Dermatitis neglecta -- A dirty dermatosis: Report of three cases. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372914/
  5. Stewart, T. (2017). Dermatitis neglecta. https://dermnetnz.org/topics/dermatitis-neglecta