Transient Acantholytic Dermatosis Clinical Presentation

  • Author: Edward J Zabawski Jr, DO; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 25, 2012
 

History

  • One of the hallmarks of transient acantholytic dermatosis (Grover disease) is pruritus, and all individuals who are affected experience variable degrees of itching, sometimes severe in nature.
  • The clinical appearance does not always correlate to the degree of pruritus; for example, some patients with limited cutaneous disease complain of severe itching, whereas others with many lesions have few or no symptoms.
  • No systemic symptoms are associated with transient acantholytic dermatosis (Grover disease), but oral lesions can develop that resemble aphthae and may be slightly painful.[6]
Next

Physical

  • The transient acantholytic dermatosis (Grover disease) process usually begins as an eruption of the skin on the anterior part of the chest, the upper part of the back, and the lower part of the rib cage (see the images below).[7] A 54-year-old man with a pruritic eruption on the A 54-year-old man with a pruritic eruption on the trunk. Notice the slight lichenification and significant erythema from rubbing that is localized to the central part of the torso. Also note the red-brown papules in the abdominal region. Close-up view of the abdominal area of a patient wClose-up view of the abdominal area of a patient with a pruritic eruption on the trunk. Multiple, small, discrete, red-brown papules characteristic of Grover disease are present.
  • Patients who are severely affected may have disseminated disease affecting the neck, the shoulders, the arms, and the legs.
  • The scalp is usually not affected, and the palms and the soles are almost always spared.
  • Individual lesions are erythematous to red brown keratotic papules that remain discrete and do not usually tend to coalesce.
  • Occasionally, lesions may be acneiform, vesicular, pustular, and rarely even bullous. Although the most common presentation is that of widespread scattered papules, unusual distributions, including zosteriform or unilateral, may occur.[8]
Previous
Next

Causes

The etiology of transient acantholytic dermatosis (Grover disease) is unknown.

Previous
Proceed to Differential Diagnoses
 
 
Contributor Information and Disclosures
Author

Edward J Zabawski Jr, DO  Medical and Surgical Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Clay J Cockerell, MD  Director, Clinical Professor, Department of Dermatology, Division of Dermatopathology, University of Texas Southwestern Medical Center

Clay J Cockerell, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, International Academy of Pathology, International AIDS Society, International Society for Dermatologic Surgery, North American Clinical Dermatologic Society, Society for Investigative Dermatology, and Southern Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Donald Belsito, MD  Professor of Clinical Dermatology, Department of Dermatology, Columbia University Medical Center

Donald Belsito, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Dermatology Foundation, New York County Medical Society, New York Dermatological Society, Noah Worcester Dermatological Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Julia R Nunley, MD  Professor, Program Director, Dermatology Residency, Department of Dermatology, Virginia Commonwealth University Medical Center

Julia R Nunley, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Nephrology, International Society of Nephrology, Medical Dermatology Society, Medical Society of Virginia, National Kidney Foundation, Phi Beta Kappa, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Grover RW. Transient acantholytic dermatosis. Arch Dermatol. Apr 1970;101(4):426-34. [Medline].

  2. Streit M, Paredes BE, Braathen LR, Brand CU. [Transitory acantholytic dermatosis (Grover disease). An analysis of the clinical spectrum based on 21 histologically assessed cases]. Hautarzt. Apr 2000;51(4):244-9. [Medline].

  3. Scheinfeld N, Mones J. Seasonal variation of transient acantholytic dyskeratosis (Grover's disease). J Am Acad Dermatol. Aug 2006;55(2):263-8. [Medline].

  4. Fujita Y, Sato-Matsumura KC, Ohnishi K. Transient acantholytic dermatosis associated with B symptoms of follicular lymphoma. Clin Exp Dermatol. Nov 2007;32(6):752-4. [Medline].

  5. Ishibashi M, Nagasaka T, Chen KR. Remission of transient acantholytic dermatosis after the treatment with rituximab for follicular lymphoma. Clin Exp Dermatol. Mar 2008;33(2):206-7. [Medline].

  6. Kanzaki T, Hashimoto K. Transient acantholytic dermatosis with involvement of oral mucosa. J Cutan Pathol. Feb 1978;5(1):23-30. [Medline].

  7. Fantini F, Kovacs E, Scarabello A. Unilateral transient acantholytic dermatosis (Grover's disease) along Blaschko lines. J Am Acad Dermatol. Aug 2002;47(2):319-20. [Medline].

  8. Liss WA, Norins AL. Zosteriform transient acantholytic dermatosis. J Am Acad Dermatol. Nov 1993;29(5 Pt 1):797-8. [Medline].

  9. Gilchrist H, Jackson S, Morse L, Nicotri T, Nesbitt LT. Galli-Galli disease: A case report with review of the literature. J Am Acad Dermatol. Feb 2008;58(2):299-302. [Medline].

  10. Fernández-Figueras MT, Puig L, Cannata P, Cuatrecases M, Quer A, Ferrándiz C, et al. Grover disease: a reappraisal of histopathological diagnostic criteria in 120 cases. Am J Dermatopathol. Aug 2010;32(6):541-9. [Medline].

  11. Helfman RJ. Grover's disease treated with isotretinoin. Report of four cases. J Am Acad Dermatol. Jun 1985;12(6):981-4. [Medline].

  12. Miljkovic J, Marko PB. Grover's disease: successful treatment with acitretin and calcipotriol. Wien Klin Wochenschr. 2004;116 Suppl 2:81-3. [Medline].

  13. Breuckmann F, Appelhans C, Altmeyer P, Kreuter A. Medium-dose ultraviolet A1 phototherapy in transient acantholytic dermatosis (Grover's disease). J Am Acad Dermatol. Jan 2005;52(1):169-70. [Medline].

 
Previous
Next
 
A 54-year-old man with a pruritic eruption on the trunk. Notice the slight lichenification and significant erythema from rubbing that is localized to the central part of the torso. Also note the red-brown papules in the abdominal region.
Close-up view of the abdominal area of a patient with a pruritic eruption on the trunk. Multiple, small, discrete, red-brown papules characteristic of Grover disease are present.
Histopathology of Darier-type Grover disease. A focus of acantholytic dyskeratosis is present in the epidermis with slight epithelial hyperplasia and hyperkeratosis, a sign of rubbing as a consequence of the pruritic nature of the disease (hematoxylin and eosin, original magnification X40).
Higher magnification reveals the acantholytic dyskeratosis to better advantage. Note the corps ronds and grains (hematoxylin and eosin, original magnification X400).
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.