Diogenes Syndrome: A Case Report

Abstract

Cessation of normal skin cleansing seen in geriatric or self-neglected patients can cause accumulation of keratinous crusts on the skin. In the extreme end of this spectrum is a condition known as Diogenes syndrome (DS). These patients may have psychiatric disorders like paranoid disorders, mood affection, or temporofrontal dementia. Subjects are mainly the elderly but few cases in younger age group of patients have also been reported. Lesions of DS are usually found over upper central chest, back, and groin. In the young, lesions are mainly found over scalp, face, or arms. Absence of normal skin cleaning causes keratin and dirty debris to accumulate and with time form a thick shell. These debris can be secondarily infected by bacteria, fungus, and so forth. These skin lesions are not usually seen in individual with proper hygiene. We report a case of Diogenes syndrome in a 34-year-old young male patient who had associated schizophrenia.

Recognizing Diogenes syndrome: a case report

“…It is often associated with other mental illnesses, such as schizophrenia, mania, and frontotemporal dementia [ 4 ]. While no clear etiology exists, it is hypothesized that it may be due to a stress reaction in people with certain pre-morbid personality traits, such as being aloof, or certain personality disorders, such as schizotypal or obsessive compulsive personality disorder [ 5 , 6 ]. There are suggestions that an orbitofrontal brain lesion may lead to such behaviours [ 7 ], while others state that chronic mania symptoms, such as poor insight, can lead to such a condition [ 4 ].…”

Diogenes Syndrome: Identification and Distinction from Hoarding Disorder

“…As noted by Ferry [ 8 ], and as evidenced in the case presented here, “Diogenes syndrome is often identified by chance (e.g., a person collapses and trapped in rubbish)” (p. 29). Further, the disorder appears to follow a “distinct sociodemographic profile where it is found that persons are usually single, aged, having average or above-average intelligence, and also having good income” ([ 7 ], p. 2; [ 26 ]).…”

“…He claimed that no one had entered his apartment during the entire time he resided there. Accordingly, it has been hypothesised that Diogenes is a stress response in individuals with certain premorbid personality traits, such as being socially withdrawn or aloof [ 7 , 10 ]. Nevertheless, given the broad psychosocial and health implications of this syndrome, it is clear that specialised psychotherapeutic and social support is required in the treatment of these cases [ 27 ].…”

Eponyms in the dermatology literature linked to Greece

“…Diogenes syndrome [5,6] Cessation of normal skin cleansing seen in geriatric or self-neglected patients can cause accumulation of keratinous crusts on the skin. In the extreme end of this spectrum is a condition known as Diogenes syndrome (DS).…”