Terra firma forme dermatosis dell’areola

Terra firma forme dermatosis (TFFD), is a dermatosis first described in 1987 by Duncan. It is a benign lesion and looks like a cutaneous localized discoloration that can be removed only by rubbing it with isopropyl alcohol. Its origin is still unknown. Onset can be at any age, sex and region. The differential diagnosis includes many various diseases. This article presents the case of a 16 year-old female patient who had an asyptomatic hyperpigmented linear lesion in her right nipple and areola. The biopsy excluded the linear epidermal nevus. Authors suspected dermatosis neglecta, but they tried to wash the lesion with soap and water without any result. It was easily rubbed off with alcohol, which confirmed the diagnosis of TFFD. Only 17 cases have been published and the present one is the first in which the lesion is localized in the nipple in a linear pattern. As recently nine cases of cloracne, whose pathogenesis of is almost known, have been diagnosed and some histological similarities with TFFD have been noticed, the authors provide a possible pathogenesis of the latter as it is still remains unknown. Dermatologists should be aware of this dermatosis. Despite the fact that it has such a simple treatment, it is often under-diagnosed.