Terra firma‐forme dermatosis: a systematic review

Abstract

Terra firma‐forme dermatosis (TFFD) is an acquired pigmentation disorder that promptly regresses after applying isopropyl alcohol 70%. The clinical presentation ranges from patches of brownish discoloration to velvety hyperkeratotic plaques. Critical analyses of current data are lacking, so etiologies, pathogenesis, and disease associations are still debated in the literature. A literature search was done in the PubMed and Google Scholar databases to identify the published papers reporting clinical cases of TFFD. Of 102 papers screened, 64 met the including criteria. Overall, the records of 256 patients presenting a mean age of 18.34 years and a female:male ratio of 1:37 were reviewed. The present article aims to provide a key point‐summary regarding the clinical outcome, associated comorbidities, pathogenesis, histopathology, dermoscopy, and therapeutic modalities of TFFD.

Dermatosis neglecta

“…Dermoscopic findings of DN are well‐delimited cornflake‐like brown waxy scales with absent pigmentary network (Fig. 8), 35 with one report describing polygonal areas of brownish pigmentation 34 …”

Cobblestone-like rashes on the penis

“…Terra firma-forme dermatosis (TFFD). TFFD is a keratin retention disorder favoured by constitutional or acquired factors 12. This is an acquired cutaneous pigmentation disorder characterised by brown to black patches or plaques with a dirt-like appearance 3.…”

“…A retrospective study found a 2.19% prevalence in a group of 869 outpatients 4. Another systematic review included 256 patients with TFFD presenting at a mean age of 18 years and a ratio of male to female of 1:1.37 1. TFFD has a possible link with atopy (atopic dermatitis, asthma, and allergic rhinitis) 15.…”

“…Another systematic review included 256 patients with TFFD presenting at a mean age of 18 years and a ratio of male to female of 1:1.37 1. TFFD has a possible link with atopy (atopic dermatitis, asthma, and allergic rhinitis) 15. It preferentially involves the trunk, extremities, and skin folds (neck, axilla, inguinal region, umbilical fold).…”

“…Differential diagnoses include dermatosis neglecta, acanthosis nigricans, verrucous naevi, ichthyosis, seborrhoeic keratosis, pityriasis versicolor, dirty neck syndrome, and confluent and reticulated papillomatosis 12…”