North Texas Research Forum 2025
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Division
North Texas
Hospital
Medical City Fort Worth
Specialty
Dermatology
Document Type
Poster
Publication Date
2025
Keywords
Terra Firma-Forme Dermatosis, hyperkeratotic patches, case reports
Disciplines
Dermatology | Medicine and Health Sciences | Skin and Connective Tissue Diseases
Abstract
Terra Firma-Forme Dermatosis (TFFD), also known as Duncan’s dirty dermatosis is a benign, asymptomatic dermatologic condition characterized by well-demarcated brown patches to hyperkeratotic papules or plaques. It most commonly affects the neck, trunk, and face but can appear on other body regions. A key diagnostic feature is that these lesions persist despite routine washing with soap and water but can be removed by forcibly wiping the affected area with 70% isopropyl alcohol, revealing normal underlying skin. The exact etiology of TFFD remains unknown, though it is thought to involve abnormal keratinization or delayed desquamation. This condition is often underdiagnosed or misdiagnosed as dermatitis neglecta, acanthosis nigricans, or other hyperpigmented disorders, leading to unnecessary interventions or patient distress. Increased awareness of TFFD can prevent misdiagnosis and ensure proper management.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Lim, Henry; do Valle, Rafael; Ayoub, Reem; Hall, Marshall; Carletti, Michael; and Weis, Stephen, "Clinical Evaluation and Management of Terra Firma-Forme Dermatosis: Insights from Two Diverse Cases" (2025). North Texas Research Forum 2025. 110.
https://scholarlycommons.hcahealthcare.com/northtexas2025/110