A Case of Terra Firma-Forme Dermatosis: Differentiation from Other Dirty-Appearing Diseases

Vol. 28, No. 3, 2016 413 Received June 23, 2015, Revised July 15, 2015, Accepted for publication July 20, 2015 Corresponding author: Hyun-sun Park, Department of Dermatology, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea. Tel: 82-2-870-2880, Fax: 82-2-870-0714, E-mail: [email protected] This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © The Korean Dermatological Association and The Korean Society for Investigative Dermatology DTE and morpheic BCC can exhibit basaloid cells in strands and sclerotic stroma. However, neither cellular atypia nor peripheral palisading are seen in DTE, and morpheic BCC is not usually associated with horn cyst formation. Also, in most DTE, retained or increased CK20-positive Merkel cells are found, but not in morpheic BCC. Scar should be considered if multiple depressed macules appear, but it can be easily differentiated based upon its histopathology. The treatment of choice is surgical excision and Mohs micrographic surgery is recommended to achieve clear surgical margins. In our case, because multiple lesions had developed and tumor strands extended into the deep dermis, total excision was performed to exclude malignancy. Therefore, initial proper biopsy is important to make an accurate diagnosis and treatment in patients with multiple scar-like depressed macules on face. Herein, we report a rare case of multiple DTE, which should be differentiated from malignancy histopathologically.