Terra Firma-Forme Dermatosis: A Heart-Shaped Dark Lesion in a Boy.

Terra firma-forme dermatosis is an acquired and idiopathic disorder with an underestimated incidence. It is characterized by brownish skin pigmentation, forming asymptomatic plaques that give a soiled skin appearance. Soap and water have a minor effect; however, friction with 70% ethyl or isopropyl alcohol immediately eliminates plaques to a normal skin appearance, thus being the ideal method for diagnosis and treatment. The lack of familiarity with this disease possibly contributes to an alarming underdiagnosis. In this report, the authors present a case of terra firma-forme occurring in a 14-year-old Mexican patient who presented with a heart-shaped pigmented lesion in the pubic area.