Dermatosis neglecta (DN) is a frequently underdiagnosed and under-reported dermatological entity, which occurs due to unconscious neglect of self-cleaning in individuals with some underlying physical or mental pathology. The lack of cleaning leads to accumulation of scales, dirt, sweat and sebum compacted together in the skin. Owing to its asymptomatic nature, diverse background and deceptive clinical presentation, DN is often missed or misdiagnosed by physicians. Awareness and recognition of this condition is essential to avoid unnecessary diagnostic and treatment procedures. The focus of this review article is to provide insights into this condition. We also intend to develop an algorithm for practical approach to a clinical diagnosis of dirt-like dermatoses with reasonable accuracy. A few interesting cases of DN encountered in our institution are included in this article.