I've certainly known people with ASD claim to be completely disinterested with what others think of them, but I think anybody who is universally disliked and disrespected is very likely to find themselves at a serious disadvantage when they want anybody to help them. Maybe those who don't see that have no social imagination at all. In my case, it's a compromise. I find it's just too uncomfortable to bend my behaviour towards what I think people would approve of all the time, so I give them something towards what I imagine they want, but there's a serious limit on how far I'll go before I lose patience with it. I feel quite a bit of contempt towards their demands because of the pain they give me. But I suppose I do keep falling into the trap of projecting my own perfectionism onto them, and thinking that if they see any results of mine that aren't perfect, they'll look down on me for it.
I don't think it's much about egotism, I think that would only be the case if somebody thought they were perfect and kept showing off their perfect results to everybody so they'd be adored for it and become some kind of revered idol. I'm possibly "guilty" of egotism because I tend to write and talk about myself a lot, but I don't see myself as conceited, I don't present myself as anything special. I think the very word egotism has two rather different meanings, and that there's a danger of seeing natural and normal self-interest as highly undesirable, because the word meshes that normal and harmless tendency with some kind of narcissism. I think it's perfectly OK to want to impress people with good results and to be interested in yourself and how well you do things, and to want good social standing, or prestige, as long as you don't start getting designs on being some kind of elite figure.
I suppose to tell whether you have perfectionism or a big interest in your prestige, you might look at how you do tasks that nobody else is likely to appraise. In my case I don't think anybody would be remotely interested in whether I weigh out 499.9g or 500.0g of flour when I bake a loaf, but I often find myself taking the matter very seriously, so I think there's at least a dimension of my perfectionism that has nothing to do with prestige. When I perform music I like to go down as well as possible, and it can lift my mood very well when I do, I like the little bit of admiration or prestige people sometimes give me for it, because it redresses the balance - there probably isn't much else about me that very many people admire, and in most other respects I don't feel popular at all. I work hard to get my music sounding as good as possible, but I don't know if that's because I want the prestige or just because I enjoy working it up to the best result I can get. I've often felt that it's unlikely anybody notices most of the small improvements I make to it, but that doesn't stop me making them.