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Burak Tekin, Hulya Guc Ozmen, Tugba Kevser Uzuncakmak, Terra firma-forme dermatosis: a benign cutaneous entity with no systemic manifestations, Postgraduate Medical Journal, Volume 93, Issue 1105, November 2017, Pages 712–713, https://doi.org/10.1136/postgradmedj-2017-134982
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A 15-year-old girl was evaluated for a 4-month history of brownish discolouration on her abdomen. Her medical and family history was unremarkable. Dermatological examination revealed somewhat reticular palpable plaques with a velvety texture, especially prominent on the anterolateral aspects of the abdomen (figure 1A). A diagnosis of terra firma-forme dermatosis (TFFD) was suspected based on the patient’s general well-being and cleanliness combined with the morphology of the skin lesions. Furthermore, it was confirmed by a positive alcohol swab test, in which wiping of the affected areas with a swab soaked in 70% ethyl alcohol resulted in almost complete disappearance of the discolouration, with mild frictional erythema (figure 1B).
TFFD, also known as Duncan’s dirty dermatosis, is a benign disorder of keratinocyte retention characterised by dark brown-blackish patches and plaques. It is not attributable to systemic diseases.1–3 The name is derived from the Latin phrase ‘terra firma’ which refers to dry land.4 The lesions can be wiped using a swab soaked in 70% ethyl alcohol, but they persist after wiping with water, various cleansers or soaps.1–4 Of note, Chun and coauthors reported a patient with facial TFFD in whom the lesion was removed using alcoholic cotton peeling with 20% salicylic acid.5
