Terra Firma-Forme Dermatosis, Keratotic Form

Terra firma-forme dermatosis (TFFD) is a condition that presents as hyperpigmented patches or plaques that have a dirt-like resemblance. A keratotic form of TFFD that has not been previously reported is described in this case. The diagnosis and treatment for this condition, the alcohol swab test, did not lead to resolution of the patch in our patient. The keratotic papules had to be removed by using the edge of a microscope slide. This case report serves to provide awareness of this unique, keratotic variant that cannot be removed by wiping with isopropyl alcohol.