An early 60's-year-old woman with breast cancer, undergoing chemotherapy by central venous catheter (CVC) in the right subclavian vein, had experienced abdominal pain, intractable vomiting for two days and an isolated fever spike. She enters the Emergency Room (ER) with a Glasgow Coma Scale of 7, hypotension and desaturation. Blood gas analysis revealed respiratory failure, severe anaemia (haemoglobin 4.9 mg/dL) and hyperlactacidemia....

Terra firma-forme dermatosis (TFFD) is an uncommon keratinization disorder presenting as persistent hyperpigmented plaques that fail to clear with routine washing. We report a case of an adolescent girl with multiple lesions unresponsive to multiple topical therapies. The diagnosis was established clinically and confirmed by complete removal of the plaques with 70% isopropyl alcohol. This case highlights that, although treatment is simple and immediately effective, limited awareness of TFFD can ...