Terra firma-forme dermatosis: a benign cutaneous entity with no systemic manifestations

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...

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