Terra Firma - Forme Dermatosis in Middle Anatolia, Turkey


  • Emine Ünal
  • Müzeyyen Gönül
  • Seray Çakmak
  • Işıl Deniz Oğuz
  • Pınar Döner

J Turk Acad Dermatol 2016;10(2):0-0


Terra firma- forme dermatosis (TFFD) is a disorder which is characterized by dirt-like pigmentation, brown patch and plaques which cannot be removed by normal habit of washing and cleaning agents. TFFD is diagnosed by disappearance of hiperpigmentation after rubbing with 70% isopropyl alcohol or ethyl alcohol. Many patients have a history of various unnecessary endocrinological investigations due to concerns about a potential diagnosis of acanthosis nigrikans and insulin resistance.

Material and Methods:

In the last two year, we have diagnosed 14 patients as TFFD who applied to our clinics with compliant of hyperpigmentation. We analyzed demographical features of these cases and compare them with the literature.


In our study 14 patients were diagnosed as TFFD. Ten of them were female and 4 were male. Female/male ratio was 2.5. 9 of them were child and 5 of them were adult. The most common localizations were arm, neck and abdomen, others localizations were leg, thigh, ankle, back. In 3 patient multi-side involvement was detected. The median duration of lesions was 42.4 months.


This report is the largest case serie from Turkey. We think the incidence in our country is high than reported. In Turkey TFFD is probably misdiagnosed or not reported by dermatologists or pediatrics. If we remember this disease we can diagnose and treat patients easily, we can protect our patients from unnecessary tests and side effects of topical corticosteroids.

Keywords: Hyperpigmentation, 70% isopropyl alcohol, Pigmentation disorder