Background
This is a relatively common skin rash that is probably underdiagnosed. Grover's disease is probably the better diagnostic term since not all cases are transient. It is characterized by an itchy (pruritic) eruption that may last an average of 10-12 months. It is characterized by papules and papulovesicles with excoriations occurring on the chest, back, lower sternum, arms, and thighs.
OUTLINE
DISEASE ASSOCIATIONS CHARACTERIZATION Actinic damage Atopic dermatitis Asteatotic eczema Allergic contact dermatitis Chronic renal failure
Grover's disease in patients with chronic renal failure receiving hemodialysis: clinicopathologic review of 4 cases.Casanova JM, Pujol RM, Taberner R, Egido R, Fernandez E, Alomar A.
Departments of Dermatology, Pathology, and Nephrology, Hospital Universitari Arnau de Vilanova, Facultat de Medicina de Lleida, Spain.
J Am Acad Dermatol 1999 Dec;41(6):1029-33 Abstract quote In 4 patients undergoing hemodialysis for chronic renal failure, a transient or persistent, papular and keratotic eruption developed on the trunk and arms.
Histologic examination disclosed focal acantholysis with dyskeratosis. The lesions were clinically and histologically indistinguishable from those of Grover's disease. A possible association with Grover's disease and chronic renal failure and/or hemodialysis is postulated. Possible implicated pathogenic mechanisms are discussed.
We suggest that Grover's disease should be included in the differential diagnosis of cutaneous eruptions in patients with chronic renal failure.
Drugs
Transient acantholytic dermatosis induced by recombinant human interleukin 4.Mahler SJ, De Villez RL, Pulitzer DR.
Division of Dermatology, University of Texas Health Science Center, San Antonio 78284-7876.
J Am Acad Dermatol 1993 Aug;29(2 Pt 1):206-9 Abstract quote BACKGROUND: Interleukin 4 is one of many cytokines under investigation about its possible role in the pathogenesis and treatment of disease. Transient acantholytic dermatosis is of uncertain origin. It has not previously been linked to drug ingestion and is generally not believed to have an immunologic basis.
OBJECTIVE: Our purpose was to describe the clinical characteristics and histologic features of a cutaneous eruption caused by interleukin 4.
METHODS: Three patients in whom an eruption developed after they received intravenous recombinant human interleukin 4 were examined and biopsy specimens were evaluated.
RESULTS: These patients had a pruritic papulovesicular eruption that was consistent, both clinically and histologically, with transient acantholytic dermatosis. None of the other conditions believed to precipitate transient acantholytic dermatosis was present in our patients.
CONCLUSIONS: This is the first report of a cutaneous side effect of interleukin 4. This may be antibody-mediated or related to increased production of tissue-type plasminogen activator.
Excessive heat
Transient acantholytic dermatosis (Grover's disease). A skin disorder related to heat and sweating.Hu CH, Michel B, Farber EM.
Arch Dermatol 1985 Nov;121(11):1439-41 Abstract quote We report seven cases of transient acantholytic dermatosis (Grover's disease) to exemplify a causal association with heat and sweating.
The excessive heat and sweating was related to the use of a hot tub, a hot water bottle, a steam bath, an electric blanket, the prolonged wearing of a polyester suit, and postoperative bed confinement.
Immunocompromised states Ionizing radiation LEUKEMIA CUTIS
- A case of Grover's disease with syringoma-like features and leukemia cutis.
Garcia-Rio I, Delgado-Jimenez Y, Aragues M, Fernandez-Herrera J, Fraga J, Garcia-Diez A.
Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain.
J Cutan Pathol. 2006 Jun;33(6):443-6. Abstract quote
Leukemia cutis used to be a late manifestation of leukemia. On the other hand, Grover's disease has been described in the setting of cancer.
Case Report: A patient diagnosed as having a chronic myelomonocytic leukemia presented with lichenoid, slightly infiltrated plaques on the anterior aspect of his thorax and abdomen and papulovesicles on his back. A skin biopsy showed the co-existence of leukemia cutis, Grover's disease, and syringoma-like features.
Discussion: We discuss and comment upon this unusual association.Myelodysplasia Myelodysplastic syndrome and transient acantholytic dermatosis.
Rockley PF, Bergfeld WF, Tomecki KJ, Brydon JK.
Department of Dermatology, Cleveland Clinic Foundation, Ohio.
Cleve Clin J Med 1990 Sep;57(6):575-7 Abstract quote Focal acantholytic dyskeratosis consistent with the clinical and histological features of Darier's type of transient acantholytic dermatosis occurred in a man with myelodysplasia.
Topical steroids and systemic antihistamines provided temporary and moderate relief from pruritus, but failed to control the dermatosis.
Piebaldism
Grover disease (transient acantholytic dermatosis) and piebaldism.Kiwan RA, Mutasim DF.
Department of Dermatology, University of Cincinnati College of Medicine, Ohio 45267-0592, USA.
Cutis 2002 Jun;69(6):451-3 Abstract quote A 35-year-old white man with lifelong stable white lesions on the anterior trunk and extremities presented with a pruritic papular eruption limited to the white patches. Results of a histologic examination led to a diagnosis of Grover disease (transient acantholytic dermatosis).
To our knowledge, this article is the first to report an association between Grover disease and piebaldism or other depigmented disorders. We review the literature and speculate on the association between these conditions.
Sweating
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Last Updated September 7, 2010
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