Grover's Disease - Causes, Symptoms and Treatment

Definition

Grover's disease is also known as transient acantholytic dermatosis. It is a condition that appears suddenly as itchy red spots on the trunk, most often in older men. Minor cases of Grover's disease may be rather common. Sometimes the features of Grover's are found in people who do not itch or have a conspicuous rash. Most of the people with Grover's who visit a dermatologist, however, itch a lot. It is a skin condition affecting the chest and back. It is a rare temporary skin disorder. Under a microscope one finds separation of closely connected cells in the skin's outer layers that can be identified by a dermatologist. Small blisters containing a watery liquid are present. These blisters tend to group and have a swollen red border around them. Grover's Disease is mainly seen in males over the age of forty. Its cause is unknown but it is thought to be related to trauma to sun damaged skin.

Causes

1. The cause of Grover’s disease is unknown.
2. It follows sweating or some unexpected heat stress, so there has been suspicion that it may relate to the sweat ducts in some way.
3. It also may arise in quite dry skin. In a lot of chances it is found that this disease has occurred in dry skin people.
4. Sun damage may also be the cause of the Grover’s disease.
5. Sex may also be a cause of this disease. Men are affected 3 times more often than women.
6. Grover disease most commonly affects middle-aged men; however, it has been in reported in children.

Symptoms

1. There may be small, firm, raised red lesions on the skin in this disease.
2. There may present small blisters containing a watery liquid.
3. Grover's disease often starts quite suddenly. It results in very itchy spots on the central back, mid chest and occasionally elsewhere. Frequently, it follows sweating or some unexpected heat stress.
4. In this disease papules and papulovesicles with excoriations occurring on the chest, back, lower sternum, arms, and thighs.
5. Slight bleeding may occur sometime. Generally bleeding occurs when there is a lot of scratching.

Treatment

1. The disease is eventually self-limited and often no treatment is needed, other than moderate strength topical glucocorticoids if there is significant pruritus.
2. Potent topical corticosteroids may be effective in diminishing inflammation and in controlling itching.
3. For refractory disease, retinoids, such as vitamin A 50,000 U 3 times a day for 2 weeks then daily for up to 12 weeks or isotretinoin 40 mg/day for 2-12 weeks, may be effective.
4. Apply a mild topical steroid such as hydrocortisone in a cool lotion. It can be applied frequently to the affected areas to relieve itching.
5. Oral retinoids such as acitretin or isotretinoin have been reported to be helpful. However, they have important side effects and are not necessary for mild cases.
6. Excess heat and sweating are frequently associated with an increase in the symptoms of Grover disease. Activities that cause these symptoms should be avoided.