Terra firma-forme dermatosis is a relatively common but probably underestimated entity characterized by asymptomatic cutaneous pigmentation resembling dirty skin. Dermoscopy is a non-invasive diagnostic tool used in the diagnosis of many cutaneous conditions. In this study we aimed to reveal dermoscopic patterns of the entity. A total of 10 patients diagnosed with terra firma-forme dermatosis were enrolled. The most common dermoscopic pattern was polygonal brown clods arranged in a mosaic pattern (N=7). The other patterns observed were seborrheic keratosis-like pattern (N=2) and perifollicular hyperpigmentation (N=1). Rubbing with 70% ethyl alcohol resulted in complete resolution of the lesions in all patients.

Amyloidosis cutis dyschromica (ACD) is a rare form of primary cutaneous amyloidosis. ACD, first described by Morishima in 1970 is characterized by (i) macular, speckled, reticular hyperpigmentation with hypopigmented spots distributed extensively over the body; (ii) little or no pruritus; (iii) prepubertal onset; and (iv) focal subepidermal amyloid deposition. A 49-year-old woman presented with a 20-year history of progressive, asymptomatic, generalized mottled hyper- and hypopigmented macules all over the body. Histopathological examination of a punch biopsy specimen showed deposition of homogeneous, eosinophilic material in the papillary dermis. This amorphous, eosinophilic material was stained metachromatically with crystal violet stain and found to be compatible with amyloid. Based on the clinical and histopathological findings, the patient was diagnosed as having ACD. Amyloidosis cutis dyschromica must be considered in the differential diagnosis of patients with diffuse dyschromatosis including both hyperpigmented and hypopigmented lesions and histopathological confirmation is necessary in order to reach a correct diagnosis.