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PHOTO ESSAY
Year : 2021  |  Volume : 1  |  Issue : 3  |  Page : 439-440

Dermatitis passivata over eyebrow mimicking seborrheic keratosis: A peculiar complication following cataract surgery


Department of Dermatology, Venereology and Leprology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India

Date of Submission24-Sep-2020
Date of Acceptance23-Feb-2021
Date of Web Publication02-Jul-2021

Correspondence Address:
Dr. Jaspriya Sandhu
Assistant Professor, Department of Dermatology, Venereology and Leprology, Dayanand Medical College and Hospital, Ludhiana, Punjab - 141 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2983_20

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  Abstract 


Keywords: Dermatitis neglecta, dermatitis passivata


How to cite this article:
Sandhu J, Singh A, Gupta SK, Singla P. Dermatitis passivata over eyebrow mimicking seborrheic keratosis: A peculiar complication following cataract surgery. Indian J Ophthalmol Case Rep 2021;1:439-40

How to cite this URL:
Sandhu J, Singh A, Gupta SK, Singla P. Dermatitis passivata over eyebrow mimicking seborrheic keratosis: A peculiar complication following cataract surgery. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Jul 26];1:439-40. Available from: https://www.ijoreports.in/text.asp?2021/1/3/439/320333



Dermatitis passivata, a subset of dermatitis artefacta, occurs when willful neglect and lack of frictional cleaning manifests as a hyperkeratotic skin lesion. It is seen more commonly in the geriatric population due to neglect; while in younger individuals, it may be associated with psychiatric comorbidities.[1] Lack of personal hygiene and exfoliation results in a verrucous often pigmented plaque with cornflake-like scales.[2] Its most severe form may be a component of Diogenes syndrome, which is a behavioral disorder, characterized by living in extreme squalor, a neglected physical state, and unhygienic conditions. We present here a peculiar case of dermatitis passivata following cataract surgery.

A 60-year-old woman was referred to us from the ophthalmology clinic for a hyperpigmented lesion over the left eyebrow for the last 3 months; which had developed 10 months after cataract surgery. Since the surgery, the patient had stopped cleaning the area around the eye. On examination, a well-defined, crusted, hyperpigmented plaque (4 × 8 cm2) was seen over the left eyebrow extending onto the eyelid as well as the forehead [Figure 1].
Figure 1: A hyperpigmented, crusted plaque present over the eyebrow extending onto the forehead and upper eyelid

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We made a provisional diagnosis of dermatitis passivata and the patient was prescribed sodium bicarbonate soaks followed by cleansing with a Syndet soap twice daily; marked improvement was seen after 1 month with complete resolution at 6 months [Figure 2]. Thus, a final diagnosis of dermatitis passivata mimicking a seborrheic keratosis was made.
Figure 2: Complete resolution of the lesion at 6-month follow-up

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  Discussion Top


Dermatitis passivata may be confused for a verrucous nevus, acanthosis nigricans, hyperpigmented Malassezia dermatitis, and postinflammatory hyperpigmentation.[3],[4] Similar to our case, Panda et al. reported three cases with dermatitis passivata post-cataract surgery.[5] A peculiar feature was the localization of the lesion to the area around the eye, with overall good hygiene. To our knowledge, such a morphological pattern of dermatitis passivata mimicking seborrheic keratosis has not been reported after cataract surgery. We would like to emphasize the importance of its awareness among both dermatologists and ophthalmologists to prevent undue diagnostic investigations.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kwon EJ, Dans M, Koblenzer CS, Elenitas R, James WD. Dermatitis artefacta. J Cutan Med Surg 2006;10:108-13.  Back to cited text no. 1
    
2.
Sanchez A, Duran C, de la Luz-Orozco M, Saez M, Maldonado RR. Dermatosis neglecta: A challenge diagnosis. Dermatol Pediatr Lat 2005;3:45-7.  Back to cited text no. 2
    
3.
Lucas JL, Brodell RT, Feldman SR. Dermatosis neglecta: A series of case reports and review of other dirty-appearing dermatoses. Dermatol Online J 2006;12:5.  Back to cited text no. 3
    
4.
Boralevi F, Marco-Bonnet J, Lepreux S, Buzenet C, Couprie B, Taïeb A. Hyperkeratotic head and neck Malassezia dermatosis. Dermatology 2006;212:36-40.  Back to cited text no. 4
    
5.
Panda M, Patro N, Samant S, Arora S. Dermatitis neglecta as a complication after cataract surgery. Indian J Ophthalmol 2016;64:231-2.  Back to cited text no. 5
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