Dermatology clinical case


  • Sofia Pires Department of Pediatrics, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra
  • Ana Teresa Gil Department of Urgency, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra



Duncan’s dirty disease, keratinization disorder, terra firma-forme dermatosis


The case of a child with terra firma-forme dermatosis lesions is reported. This is an idiopathic and uncommon condition characterized by asymptomatic dirt-like lesions, which cannot be removed by routine cleaning. Lesions completely disappear after swabbing with 70% isopropyl alcohol. The condition is more frequent in children and often occurs on the neck, trunk, and ankles.


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1. DuncanWC, Tschen JA, Knox JM. Terra firma-forme dermatosis. Arch Dermatol 1987; 123:567–9.

2. Santarpia M, Guarneri C. Terra firma-forme dermatosis. Eur J Intern Med. 2016; 34:e1-2.

3. Solak B, Erdem T. Terra firma-forme dermatosis: wipe first. Int J Dermatol. 2015; 54:e548-9.

4. Berk DR. Terra firma-forme dermatosis: a retrospective review of 31 patients. Pediatr. Dermatol. 2012; 29:297-300.

5. Akkash L, Badran D, Al-Omari AQ. Terra firma forme dermatosis. Case series and review of the literature. J Dtsch Dermatol Ges 2009; 7:102-7.

6. Berk DR, Bruckner AL. Terra firma-forme dermatosis in a 4-month-old girl. Pediatr Dermatol. 2011; 28:79-81.

7. Guarneri C, Guarneri F, Cannavò SP. Terra firma-forme dermatosis. Int J Dermatol. 2008; 47:482-4.

8. Ratcliffe A. Williamson D, Hesseling M. Terra firma-forme dermatosis: it`s easy when you know it. Arch Dis Child. 2013; 98:520.

9. Gusdorf L, Cribier B. Clinicopathological aspects of terra firmaforme dermatosis. Ann Dermatol Venereol. 2016; 143:446-52.

10. Meseguer-Yebra C, Meseguer-Yebra P, Garrido-Rios AA, Sánchez Estella J. Terra firma-forme dermatosis. Na Pediatr (Barc). 2015; 82:e222-3.




How to Cite

Pires S, Gil AT. Dermatology clinical case. REVNEC [Internet]. 2019Jul.18 [cited 2024Jul.17];28(2):97-8. Available from:



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