Terra firma-forme dermatosis involving the genitalia: Three pediatric case reports

Abstract

Terra firma-forme dermatosis is a rare acquired keratinization disorder. Patients present with dirt-like brownish plaques on the neck, trunk, and limbs. It is often confused with dermatitis neglecta, confluent and reticulated papillomatosis, and acanthosis nigricans. Reportedly, it affects children, but genital involvement is rare. We describe three cases of uncircumcised boys with genital involvement, two of which had extragenital involvement. They all had good hygiene. Two underwent skin biopsy, and pathological examination showed papillomatosis and alternating keratinization in the stratum corneum. The disease can be diagnosed clinically by wiping off the lesions with 70% isopropyl alcohol pads, instead of water or soap.