Grover's Disease: Features, Diagnosis, Treatment

Introduction

Grover's disease is also known as, 'Persistent Acantholytic Dermatosis,' and, 'Transient Acantholytic Dermatosis.' People with more minor cases of the disease may not experience any itching, or a conspicuous rash. The majority of people with Grover's disease who visit a dermatologist experience a great deal of itching in relation to the disease.

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The disease causes frequently itchy skin yet may cause no symptoms whatsoever. Grover's disease can be triggered by bed rest and has a characteristic appearance underneath a microscope. The disease is most likely caused by blocked sweat ducts and can begin rather suddenly, resulting in itchy spots on a person's central back, mid-chest, and on occasion, elsewhere on the person's body. Grover's disease often follows heat stress.

The disease is marked by the characteristic appearance of red and bumpy spots referred to as, 'papules,' on a person's central back and mid-chest. Once the disease has been confirmed by a doctor, it can last from between six and twelve months, although on occasion it may last for longer periods of time. The period of time Grover's disease lasts is why one of the names used to refer to is includes the name, 'transient.'

Features of Grover's Disease

Grover's disease most often affects men over 50. It is less common in women or younger people. It is more common in those who are unwell in some way, but can arise in quite healthy people as well.

It often starts quite suddenly and is more common in winter than in summer. It results in small red, bumpy spots (papules) on the central back, mid chest and occasionally elsewhere. Although frequently itchy, it may cause no symptoms. The spots may be blistered, crusted or eroded. There may be slight bleeding.

Sometimes, Grover's disease can be complicated by the development of dermatitis, usually in a nummular pattern i.e with round or oval-shaped plaques. These tend to present as larger itchy patches with a dry surface, and the rash may spread to affect other areas of the body.

Causes

Medical science has not declared an exact cause of Grover's disease at this time. The disease follows sweating, or some unexpected heat stress at times, so there has been some level of suspicion that the disease might be related to a person's sweat ducts in some way. The disease also occurs in persons with unusually dry skin; however, leaving room for questions in regards to the cause. A number of persons with Grover's disease have also experienced sun damage.

Grover's disease seems to begin or worsen after exposure to temperature extremes. At other times, the disease appears for no known reason whatsoever. Grover's disease affects white males who are over the age of forty more often than others. Some of the more common symptoms of the disease include:

• Slight bleeding
• Itchy red spots occurs on the trunk
• Small, firm, raised red lesions on the skin

Diagnosing

A dermatologist might make a diagnosis of Grover's disease based upon the appearance of the rash associated with it. A skin biopsy is may be needed in order to confirm the diagnosis. Grover's disease presents a characteristic appearance under a microscope, with separated cells called, 'acantholysis,' either with or without, 'dyskeratosis,' or abnormal rounded skin cells, being present. The majority of cases of Grover's disease last less than a year, although the condition might occasionally last longer, come and go, or present with a seasonal variation.

Treatment

Minor outbreaks of Grover's disease may be controlled with prescription strength cortisone topical creams. Larger outbreaks often clear up after taking tetracycline or accutane for a period of one to three months. Should the medications fail, or if the outbreak of Grover's disease is particularly severe, PUVA phototherapy treatments, cortisone injections, or anti-fungal pills may be used as alternative forms of treatments. Treatment of Grover's disease can include the following:

• Calcipotriol cream
• Diphemanil methylsulfate powder
• Remain cool - sweating may induce more itchy spots
• Experimentally, oral retinoids such as acitretin or isotretinoin
• A mild topical steroid such as hydrocortisone in a cool lotion
• Phototherapy can be helpful, but may also provoke the disease
• Moisturizing creams or antipruritic lotions containing menthol and camphor
• A course of tetracycline or an oral anti-fungal medication such as itraconazole

Cortisone pills may clear up Grover's disease temporarily; the rash will return as soon as the person stops taking the medication. People often find the treatment to be unsatisfactory. It is important for the person to remain cool because increased sweating will increase the number of itchy and red spots associated with the disease. A mild topical steroid such as hydrocortisone may be applied on a frequent basis to the affected area to achieve a level of relief. At times, Grover's disease can be complicated by the development of dermatitis.

Author Credentials:
Thomas C. Weiss is a researcher and editor for Disabled World. Thomas attended college and university courses earning a Masters, Bachelors and two Associate degrees, as well as pursing Disability Studies. As a Nursing Assistant Thomas has assisted people from a variety of racial, religious, gender, class, and age groups by providing care for people with all forms of disabilities from Multiple Sclerosis to Parkinson's; para and quadriplegia to Spina Bifida. Explore Thomas' complete biography for comprehensive insights into his background, expertise, and accomplishments.