Terra firma-forme dermatosis is an acquired, benign and asymptomatic condition characterized by a disorder of keratinization. It’s usually presented as a brownish-black, dirt-like plaques, in patients with normal hygiene. The lesions often affect the neck, ankles, trunk and face [1-3].

A 16-year-old adolescent girl presented at her pediatric consultation with an asymptomatic brownish dirt-like lesion at the anterior region of the thorax with weeks of evolution (Figure 1). The patient thought the lesion was dirt and tried to clean it with water and soap without success. There was no history of other dermatologic conditions. There was also no history of bad hygiene habits. At the consultation, rubbing the lesion with an 70% isopropyl alcohol-soaked gauze pad and applying pressure resulted in complete disappearance of the lesion (Figure 2-3). After this consultation the adolescent girl manifested frequent recurrences of the lesions, mostly in both her arms, which always disappear after she applies an alcohol-like solution.

Both diagnosis and treatment of Terra firma-forme dermatosis consists in the application of 70% isopropyl alcohol [1-3]. It’s important to recognize this condition and not confuse this benign and easily treatable condition with other dermatologic disorders to avoid unnecessary exams and medications.

Keywords: Dermatosis; Terra Firma-forme; Duncan’s dirty