Ann Dermatol.  2017 Feb;29(1):83-85. 10.5021/ad.2017.29.1.83.

A Case of Terra Firma-Forme Dermatosis Treated with Salicylic Acid Alcohol Peeling

• Chun SW
• Lee SY
• Kim JB
• Choi HM
• Ro BI
• Cho HK

• KMID: 2368033
• DOI: http://doi.org/10.5021/ad.2017.29.1.83

Abstract

Terra firma-forme dermatosis (TFFD) is a bizarre, acquired and idiopathic dermatosis that etiology has still not been fully defined. It is characterized by the presence of asymptomatic, brownish dirt-like lesion maybe due to disorder of keratinization. These lesions cannot be removed with ordinary cleansing. Therefore, TFFD can be differentiated from dermatosis neglecta. Patient was a 17-year-old man with brownish lesions on his face for 1 month. The patient had a history of regular washing habit with soap and water. The lesions were asymptomatic however due to cosmetic reasons, the patient wanted to treat his skin lesions. Punch biopsy revealed hyperkeratosis and fungal spore are in stratum corneum. Salicylic acid peeling with alcohol base was performed on the patient's face. The skin lesions disappeared completely on gentle swabbing with peeling. In this point, the diagnosis of TFFD could be considered. Since, this disease can be confused with dermatosis neglecta, we report this case with literature review.

Keyword

Dermatosis; Dirt-like dermatosis; Terra firma-forme dermatosis

MeSH Terms

Adolescent
Biopsy
Diagnosis
Humans
Salicylic Acid*
Skin
Skin Diseases*
Soaps
Spores, Fungal
Water
Salicylic Acid
Soaps
Water

Figure

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  Fig. 1 (A) Brownish dirt-like hyperkeratotic plaque on the face. (B) After treatment.

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  Fig. 2 (A) Hyperkeratotic stratum corneum and dilated pore (H&E, ×40). (B) Clusters of budding spores in the horny layer (H&E, ×200).

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