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Papillary Dermis01:11

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The papillary and reticular dermis are the two layers of the dermis. They are made of connective tissue with fibers of collagen extending from one to the other, making the border between the two somewhat indistinct. The dermal papillae extending into the epidermis belong to the papillary layer, whereas the dense collagen fiber bundles below belong to the reticular layer.
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Dermoscopy Aids in the Diagnosis of Discoid Lupus Erythematosus
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[Terra firma-forme dermatosis].

V Pallure1, M Ameline, P Plantin

  • 1Département de dermatologie, hôpital Saint-Éloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France.

Annales De Dermatologie Et De Venereologie
|November 12, 2013
PubMed
Summary

Terra firma-forme is an acquired skin hyperpigmentation often mistaken for poor hygiene. This condition, characterized by grey-brown patches, resolves with isopropyl alcohol treatment, not soap and water.

Keywords:
Acquired hyperpigmentationDermatitis neglectaDermatose « en terre sèche »Hyperpigmentation acquiseTerra firma-forme dermatosis

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Area of Science:

  • Dermatology
  • Pediatric Dermatology

Context:

  • Terra firma-forme is a common but underreported skin condition.
  • It is often misdiagnosed as a result of poor hygiene, particularly in children.
  • The condition presents as asymptomatic grey-brown hyperpigmentation.

Purpose:

  • To report on 10 new cases of terra firma-forme.
  • To highlight diagnostic criteria and differentiate from other dermatoses.
  • To emphasize the importance of recognizing this condition in clinical practice.

Summary:

  • Terra firma-forme presents as acquired, asymptomatic, grey-brown macular or papular pigmentation, affecting children and adolescents.
  • Diagnosis is confirmed by the characteristic appearance and resolution with 70% isopropyl alcohol, not soap and water.
  • The condition is bilateral, symmetrical, and commonly affects the neck, trunk, and ankles.

Impact:

  • Accurate diagnosis prevents misattribution to poor hygiene and unnecessary investigations.
  • Understanding terra firma-forme can mitigate aesthetic and social concerns for patients.
  • Prompt recognition facilitates effective treatment with alcohol or ether, improving patient outcomes.