Terra firma-forme dermatosis

Terra firma-forme dermatosis refers to the benign skin disorder characterized by dirty-appearing areas on the skin. These areas are not actually dirty, but due to abnormal keratinization, they are being perceived as ones.

Terra firma-forme dermatosis usually affects children and adolescents. However, no large epidemiological studies have been done to determine the prevalent age group for the current skin disorder. Due to Terra firma-forme dermatosis being asymptomatic, many cases go unreported and affected individuals do not seek any medical help for this particular issue.

Terra firma-forme dermatosis is believed to be the disorder due to keratinization which is the result of abnormal and delayed development of skin cells. The adhesion between keratinocytes takes longer than usual, which causes them to develop into brown patches and thickened plaques.

In the past, it was believed that Terra firma-forme dermatosis is caused due to poor hygiene. However, affected areas tend to be resistant to normal soap. Many patients with such diagnosis have normal standards of personal hygiene.

Terra firma-forme dermatosis appears in the form of thickened, brown-black papules and plaques on face, neck, trunk, and abdomen. Sometimes it tends to affect areas around surgical sites (e.g. median sternotomy and total knee replacement).

The complications of Terra firma-forme dermatosis are associated with psychosocial stress. These spots are perceived by the public as “dirty” appearance and reflection of poor hygiene.

Dirty areas that cannot be removed with soap are usually the sign of Terra firma-forme dermatosis. Wiping the affected area with a pad soaked in 70% isopropyl alcohol will remove the lesion completely. No additional tests are usually required; however, laboratory tests for fungal infection may be requested in order to rule out other diseases.

As previously mentioned, solutions containing ethyl or isopropyl help to remove lesions completely. The mild topical keratolytic agents can be used in rare cases in order to avoid exposing larger skin sites to aggressive alcohol rubbing. Chemical peels also help to resolve the affected sites.

Terra firma-forme dermatosis is completely respondent to treatment and is 100% cured.  

Centre for Medical and Surgical Dermatology offers unique and personalized Terra firma-forme dermatosis treatment options for each patient.