Government Medical College And Hospital, India
Title: Terra firma forme dermatosis versus dermatitis neglecta: A continuing spectrum or distinct entities
Biography: Ankita Tuknayat
Terra firma forme dermatosis (TFFD) is an acquired, benign disorder of keratinization characterized by retention hyperkeratosis presenting as dirt like plaques which are resistant to washing but can be removed with forceful swabbing with alcohol pad. The exact etiopathogenesis of the disease is unknown but is thought to be due to delay in the maturation of keratinocytes, with melanin retention and accumulation of sebum & corneocytes .
A 29 years old female presented with complaints of persistent brownish-grey dirt-like skin lesions over her face and neck along with matting of hairs from last 5 years for which she had taken multiple consultations but with no relief.Histopathology was consistent with TFFD. The lesions were wiped off with isopropyl alcohol, confirming the diagnosis. On enquiring she had some psychiatric issues for which she was evaluated.
Dermatitis neglecta/passivata involves self neglect due to underlying psychological morbidity. This has not been described in the recently described TFFD . But in our patient a psychiatric component was elicited and histopathology was consistent with TFFD. This propels us to think that dermatitis neglecta and TFFD which is a new entity may be a continuum of the same spectrum.