Terra Firma-Forme Dermatosis

A 12-year-old girl with a history of alopecia areata and vitiligo presented with an asymptomatic brownish dirt-like lesion on the left postauricular skin of approximately 3 years of duration. The patient and her mother tried to clean the "dirt" with water and soap without success. There was no history of rapid weight gain. She had no history of an inflammatory dermatosis in the affected area. Physical examination revealed a dirt-like brownish plaque on the left postauricular skin (Figure 1). Rubbing of the lesion with a 70% isopropyl alcohol-soaked gauze pad and pressure resulted in complete disappearance of the lesion (Figure 2).

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