Grover disease: Difference between revisions
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* Lesions are usually pruritis |
* Lesions are usually pruritis |
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* Can form crusts and keratotic erosions |
* Can form crusts and keratotic erosions |
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* Affects trunk almost universally, but can also involve proximal and lower extremities, and, occasionally, neck and face |
* Affects trunk (including back) almost universally, but can also involve proximal and lower extremities, and, occasionally, neck and face |
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* Self-resolves over weeks to months, but occasionally can have a chronic fluctuating course lasting years |
* Self-resolves over weeks to months, but occasionally can have a chronic fluctuating course lasting years |
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** Can recur seasonally in winter and summer |
** Can recur seasonally in winter and summer |
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Revision as of 15:37, 27 September 2023
Background
- Also known as transient acantholytic dermatosis
- Risk factors
- Almost always in men
- Heat and sweating, but also cold, dry air in winder
- Chronic kidney disease
- Induction chemotherapy for transplantation
- Drugs, including sulfadoxine-pyrimethamine, recombinant IL-4, BRAF inhibitor, ipilimumab, and other immune checkpoint inhibitors
- Rarely neoplastic
Clinical Manifestations
- Self-limited, papulovesicular rash, most common in older shite men
- Lesions are usually pruritis
- Can form crusts and keratotic erosions
- Affects trunk (including back) almost universally, but can also involve proximal and lower extremities, and, occasionally, neck and face
- Self-resolves over weeks to months, but occasionally can have a chronic fluctuating course lasting years
- Can recur seasonally in winter and summer
Differential Diagnosis
- In general: Eczema, contact dermatitis, atopic dermatitis
- Rashes with histologic findings of acantholysis and dyskeratosis:
- Darier disease: autosomal dominant with similar presentation
- Hailey-Hailey disease: autosomal dominant with painful erosions, vesicles, and crusting in the neck, axeillae, groin, and perineum
- Pemphigus vulgaris: autoimmune disease with flaccid bullae and painful ulcers, often including skin and mucosa
- Galli-Galli disease: variant of Dowling-Degos disease with hyperpigmentation and pruritis, scaly papules on trunk and proximal extremities
Management
- Can include emollients (for dry skin), topical corticosteroids (for pruritus and inflammation), topical vitamin D analogues (if refractory to topical steroids), and oral antihistamines (for pruritus)
- Second-line options include oral retinoids, systemic corticosteroids, and phototherapy
Further Reading
- Aldana PC, Khachemoune A. Grover disease: review of subtypes with a focus on management options. Int J Dermatol. 2020 May;59(5):543-550. doi: 10.1111/ijd.14700. PMID: 31724740.
