Abstract
IntroductionDermatosis neglecta is an often misdiagnosed and under-diagnosed condition. In dermatosis neglecta, a progressive accumulation of sebum, sweat, keratin and other dirt and debris, occurs due to inadequate local hygiene resulting in a localized hyperpigmented patch or a verrucous plaque. Vigorous rubbing with alcohol-soaked gauze or soap and water results in a complete resolution of the lesion. This is the first case of dermatosis neglecta reported in a patient with multiple traumatic injuries.Case presentationWe report a case of a 35-year-old male Caucasian of Pakistani origin, with multiple fractures, neurological deficit and immobility sustained in a fall, leading to the development of dermatosis neglecta of the left hand.ConclusionEarly and prompt clinical recognition of this condition eliminates the need for aggressive diagnostic and therapeutic procedures.
Highlights
Dermatosis neglecta is an often misdiagnosed and under-diagnosed condition
Case presentation: We report a case of a 35-year-old male Caucasian of Pakistani origin, with multiple fractures, neurological deficit and immobility sustained in a fall, leading to the development of dermatosis neglecta of the left hand
Terra firma forme dermatosis has been used to describe a condition with similar clinical features but which is not amenable to soap and water cleansing and can only be rubbed off with vigorous alcohol swabbing [4,5,6]. It is in all probability a more severe variant of dermatosis neglecta rather than a separate clinical entity
Summary
The term dermatosis neglecta was first coined by Poskitt et al in 1995 to denote a condition in which formation of a localized hyperpigmented lesion occurs as a consequence of lack of cleanliness of a particular body part or region, usually due to some disability [1]. The patient had sustained multiple fractures of the left humerus and metacarpals, along with dislocation of the left shoulder and radial nerve palsy, in a fall about 2 months previously which had left the limb immobile and numb. Terra firma forme dermatosis has been used to describe a condition with similar clinical features but which is not amenable to soap and water cleansing and can only be rubbed off with vigorous alcohol swabbing [4,5,6]. It is in all probability a more severe variant of dermatosis neglecta rather than a separate clinical entity. Upon follow-up examination two weeks later, the hand was completely devoid of any pigmentation or verrucosity (Figure 2)
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