Dermatosis neglecta: a series of case reports and review of other dirty-appearing dermatoses.

Localized scaling and hyperpigmentation is a common finding and often a diagnostic and therapeutic challenge. Dermatosis neglecta (DN) represents a failure to adequately clean or scrub the skin, often in an area of hyperesthesia or prior trauma. We identified five cases of DN in two clinical practices in just the past few years. The condition is characterized by scrupulous avoidance of scrubbing, leading to a buildup of hyperpigmented, adherent, cornflake-like scales. An alcohol swabbing provided diagnosis and prompt clearing. Washing with soap and a washcloth also often leads to clearing. Dermatosis neglecta should be considered in the differential diagnosis of hyperpigmented scale; alcohol swabbing can serve as a diagnostic and therapeutic tool.