Cobblestone-like rashes on the penis

A young boy presented to the dermatology clinic with asymptomatic papillomatous brown plaques on his penis that had appeared two weeks previously. He denied itching, pain, or other physical complaints. There was no previous inflammation and trauma at the same site. A fungal direct microscopic examination was negative. Dermoscopy revealed multiple brown polygonal granules with a cobblestone pattern (fig 1a). The plaques were partially removed with a 75% ethyl alcohol swab (fig 1b) but had no response to cleaning with soap and water.bmj;379/oct06_4/e070996/F1F1f1Fig 1Dermoscopy showing (a) multiple brown polygonal granules with a cobblestone pattern, and (b) the granules after rubbing with a 75% ethyl alcohol swabQuestionsWhat is the most likely diagnosis?What are the differential diagnoses?How would you treat this condition?Answers1.What is the most likely diagnosis?Terra firma-forme dermatosis (TFFD). TFFD is a keratin retention disorder favoured by constitutional or acquired factors.12 This is an acquired cutaneous pigmentation disorder characterised by brown…
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