Skip to main content

Terra Firma-Forme Dermatosis and Dermatosis Neglecta

  • Chapter
  • First Online:
New and Emerging Entities in Dermatology and Dermatopathology

Abstract

Terra firma-forme dermatosis (also called “Duncan’s dirty dermatosis”) and dermatosis neglecta (or “unwashed dermatosis”) are two nosological entities characterized by hyperpigmented lesions with a “dirty” appearance. Both conditions are infrequently described in literature, but their frequency in the general population is probably underestimated, because of missed identification by physicians and/or missed reporting due to their benign nature and rapid and complete resolution, in almost all cases with simple therapeutic measures. This chapter describes the morphological characteristics of the lesions and clinical history of the two conditions, which are the basis for their recognition and distinction from other hyperpigmented skin diseases, as well as the diagnostic tests which may be used in common practice to confirm diagnostic suspicion and the histopathological aspects. Finally, an overview is given of standard and alternative treatments, used for the treatment of cases with peculiar localizations and/or particularly extensive or severe.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

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

    Google Scholar 

  2. Aslan NÇ, Güler Ş, Demirci K, Isiyel E. Features of terra firma-forme dermatosis. Ann Fam Med. 2018;16:52–4.

    Google Scholar 

  3. Sechi A, Patrizi A, Savoia F, Leuzzi M, Guglielmo A, Neri I. Terra firma-forme dermatosis: a systematic review. Int J Dermatol. 2021;60:933–43.

    Google Scholar 

  4. O’Brien TJ, Hall AP. Terra firma-forme dermatosis. Australas J Dermatol. 1997;38:163–4.

    Google Scholar 

  5. Raveh T, Gilead LT, Wexler MR. Terra firma-forme dermatosis. Ann Plast Surg. 1997;39:542–5.

    Google Scholar 

  6. Neri I, Savoia F, Tengattini V, Sechi A, Rucci P, Patrizi A. Terra firma-forme dermatosis is underestimated in children and is associated with atopic dermatitis. J Eur Acad Dermatol Venereol. 2018;32:e421–2.

    Google Scholar 

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

    Google Scholar 

  8. Borgia F, Cannavò SP. Terra firma-forme dermatosis. Clin Case Rep. 2014;2:19.

    Google Scholar 

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

    Google Scholar 

  10. Unal E, Guarneri C, Chokoeva AA, Wollina U, Tchernev G. Terra firma-forme dermatosis. Wien Med Wochenschr. 2017;167:66–9.

    Google Scholar 

  11. Unal E, Lotti J, Fioranelli M, Roccia MG, Lotti T, Guarneri C, et al. Duncan’s dermatosis: from the “terra firma-forme” to a possible syndromic condition. The story of a dirty disease. J Biol Regul Homeost Agents. 2017;31(2 Suppl. 2):39–44.

    Google Scholar 

  12. Panchal K, Bhalla N, Salunke P, Jerajani H. Extensive terra firma forme dermatosis [TFFD]: A rare presentation. Indian Dermatol Online J. 2015;6:458–9.

    Google Scholar 

  13. Chen HS, Li FG, Zhu Y, Wang T, Fan YM. Penile terra firma-forme dermatosis in a child: ultrastructural observation and topical ethacridine lactate and tacrolimus treatment. Eur J Dermatol. 2019;29:222–4.

    Google Scholar 

  14. Greywal T, Cohen PR. Non-invasive methods to establish the diagnosis of terra firma-forme dermatosis: the SMART (skin modified by alcohol rubbing test) evaluation and dermoscopy. Dermatol Online J. 2016; 22.

    Google Scholar 

  15. Cohen PR. Terra firma-forme dermatosis: rubbing with alcohol establishes the diagnosis. Skinmed. 2020;18:51–2.

    Google Scholar 

  16. Abdel-Razek MM, Fathy H. Terra firma-forme dermatosis: case series and dermoscopic features. Dermatol Online J 2015; 21.

    Google Scholar 

  17. Errichetti E, Stinco G. Dermoscopy in terra firma-forme dermatosis and dermatosis neglecta. Int J Dermatol. 2017;56:1481–3.

    Google Scholar 

  18. Ozturk DE. Chalk-white fluorescence under wood light in a case of terra firma-forme dermatosis. Clin Exp Dermatol. 2021;46:165–6.

    Google Scholar 

  19. Lora V, Ardigò M, Catricalà C, Cota C. Terra firma-forme dermatosis. J Cutan Pathol. 2014;41:141–3.

    Google Scholar 

  20. Poskitt L, Wayte J, Wojnarowska F, Wilkinson JD. ‘Dermatitis neglecta’: unwashed dermatosis. Br J Dermatol. 1995;132:827–9.

    Google Scholar 

  21. Pérez-Rodríguez IM, Muñoz-Garza FZ, Ocampo-Candiani J. An unusually severe case of dermatosis neglecta: a diagnostic challenge. Case Rep Dermatol. 2014;6:194–9.

    Google Scholar 

  22. Saha A, Seth J, Bindal A, Samanta AB, Gorai S, Sharma A. Dermatosis neglecta: an increasingly recognized entity with review of literature. Indian J Dermatol. 2016;61:450–2.

    Google Scholar 

  23. Ruiz-Maldonado R, Durán-McKinster C, Tamayo-Sánchez L, Orozco-Covarrubias ML. Dermatosis neglecta: dirt crusts simulating verrucous nevi. Arch Dermatol. 1999;135:728–9.

    Google Scholar 

  24. Qadir SN, Ejaz A, Raza N. Dermatosis neglecta in a case of multiple fractures, shoulder dislocation and radial nerve palsy in a 35-year-old man: a case report. J Med Case Rep. 2008;2:347.

    Google Scholar 

  25. Gómez-Fernández C, Casado Verrier B, Sanz Canalejas L, Moreno Alonso de Celada R, Herranz Pinto P. Cornflake-like scales on the ankles and feet. Cleve Clin J Med. 2010;77:8489.

    Google Scholar 

  26. Moon J, Park HS, Yoon HS, Cho S. A case of dermatosis neglecta caused by an inappropriate habit of applying a moisturizer. Ann Dermatol. 2017;29:657–9.

    Google Scholar 

  27. Piccolo V, Russo T, Delorenze LM, Argenziano G. Perinevic dermatosis neglecta: clinical and dermoscopic description. An Bras Dermatol. 2019;94:361–2.

    Google Scholar 

  28. Erker E, Sezer E. Dermatosis neglecta presenting as a brown verrucous plaster. Acta Dermatovenerol Croat. 2012;20:123–5.

    Google Scholar 

  29. Richter LL, Miller RM, Hillman JD, Chiu MW. Bilateral thick crusts on the legs. Int J Dermatol. 2013;52:133–5.

    Google Scholar 

  30. Saha A, Seth J, Sharma A, Biswas D. Dermatitis neglecta – a dirty dermatosis: report of three cases. Indian J Dermatol. 2015;60:185–7.

    Google Scholar 

  31. Lucas JL, Brodell RT, Feldman SR. Dermatosis neglecta: a series of case reports and review of other dirty-appearing dermatoses. Dermatol Online J. 2006;12:5.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Claudio Guarneri .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Guarneri, C., Guarneri, F., Cannavò, S.P. (2021). Terra Firma-Forme Dermatosis and Dermatosis Neglecta. In: Rongioletti, F., Smoller, B.R. (eds) New and Emerging Entities in Dermatology and Dermatopathology. Springer, Cham. https://doi.org/10.1007/978-3-030-80027-7_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-80027-7_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-80026-0

  • Online ISBN: 978-3-030-80027-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics