Bilaterally symmetrical terra firma-forme dermatosis: a diagnostic conundrum

Terra firma-forme dermatosis or dermatosis neglecta is characterized by dirty brown plaques that can be removed by forceful rubbing or with an alcohol swab. Also known as Duncan’s Dirty Dermatosis, it is usually seen at the regions of the neck, trunk, and upper extremities in children as well as adults. Here we report a patient with complaints of multiple asymptomatic dirty brown-colored, flat-topped slightly raised lesions over the face in a young girl, and emphasize its unique expression. All the lesions completely disappeared with forceful rubbing using a spirit swab, with normal underlying skin without any recurrence till date.