Demirci Gulsen Tukenmez, Mansur Ayse Tulin, Demiralay Ebru
Departments of *Dermatology, and†Pathology, Başkent University İstanbul Hospital, İstanbul, Turkey.
Am J Dermatopathol. 2017 Oct;39(10):782-784. doi: 10.1097/DAD.0000000000000885.
Terra firma-forme dermatosis (TFFD) is a clinical condition characterized by brown-gray, velvety, pigmented patches or plaques, resembling dirt on the skin. Nevoid acanthosis nigricans (NAN) is a rare and recently described form of acanthosis nigricans occurring during childhood or early adulthood. Herein we describe a patient with TFFD, initially misdiagnosed as NAN. The patient had developed hyperkeratotic and hyperpigmented plaques on and around the umbilicus during pregnancy. Though regular in bathing practices, she could not clear away the lesions and concerned marks for inesthetic appearance. Histopathological findings were compatible with NAN, and she was prescribed 10% urea lotion. On a dramatic healing after 3 weeks, a diagnosis of TFFD is considered and confirmed by the lesions getting wiped away by vigorous rubbing with alcohol pads. We discuss the key points of differentiating TFFD from NAN, and underline the importance of alcohol test for accurate diagnosis.
地衣状皮肤病变（TFFD）是一种临床病症，其特征为棕灰色、天鹅绒样、色素沉着的斑片或斑块，类似皮肤上的污垢。痣样黑棘皮病（NAN）是一种罕见的、最近才被描述的黑棘皮病形式，发生于儿童期或成年早期。在此，我们描述一名最初被误诊为NAN的TFFD患者。该患者在孕期脐部及脐周出现了角化过度和色素沉着的斑块。尽管她有规律地进行沐浴，但仍无法清除这些皮损及因外观不佳而令人担忧的印记。组织病理学检查结果与NAN相符，她被开了10%尿素洗剂。3周后皮损显著愈合，考虑诊断为TFFD，通过用酒精棉球用力擦拭可擦去皮损得以证实。我们讨论了TFFD与NAN鉴别的关键点，并强调酒精试验对准确诊断的重要性。
