||Sheets of keratin squames are constantly pushed up to the skin surface and shed during normal epidermal turnover. The outermost layer of squames is normally rubbed away by contact with clothing, or in the course of normal personal toilet. Neglect may leave patches of keratin debris accumulated within the conchal bowl or behind the ear.
The result is a pigmented, greasy, raised lesion which may, on cursory inspection, resemble an area of seborrheic keratosis. These areas of neglect keratosis can, however, be removed easily with a cotton-tipped applicator to reveal normal skin underneath.
Notice the two large, greasy, raised patches within the posterior conchal bowl