Terra Firma-Forme Dermatosis: Rubbing with Alcohol Establishes the Diagnosis

An 80-year-old man with a past medical history of basal cell carcinomas presented with an asymptomatic eruption on the chest during his biannual skin check for cancer. He had had no prior or current episodes of seborrheic dermatitis on the scalp, face, or chest. He showered and cleaned that area daily. Physical examination revealed multiple brown plaques on the upper central region of the chest (Figure 1A and B). A SMART (skin modified by alcohol rubbing test) evaluation was performed.¹ A 70% isopropyl alcohol pad was used to firmly rub the area. The brown plaques and discoloration remained on the wipes (Figure 1C). The lesions on the chest completely cleared (Figure 1D).