Grover disease: Difference between revisions
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+ | == Background == |
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− | * Papular erythematous rash with erosions that usually follows sweating or heat exposure in older men, often itchy |
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+ | * Also known as '''transient acantholytic dermatosis''' |
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+ | * Risk factors |
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+ | ** Almost always in men |
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+ | ** Heat and sweating, but also cold, dry air in winder |
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+ | ** Chronic kidney disease |
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+ | ** Induction chemotherapy for transplantation |
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+ | ** Drugs, including [[sulfadoxine-pyrimethamine]], [[recombinant IL-4]], [[BRAF inhibitor]], [[ipilimumab]], and other [[immune checkpoint inhibitors]] |
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+ | == Clinical Manifestations == |
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+ | * Self-limited, papulovesicular rash, most common in older white men |
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+ | * Lesions are usually pruritis |
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+ | * Can form crusts and keratotic erosions |
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+ | * 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 |
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+ | ** Can recur seasonally in winter and summer |
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+ | |||
+ | == Differential Diagnosis == |
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+ | |||
+ | * In general: [[Eczema]], [[contact dermatitis]], [[atopic dermatitis]] |
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+ | * Rashes with histologic findings of acantholysis and dyskeratosis: |
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+ | ** [[Darier disease]]: autosomal dominant with similar presentation |
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+ | ** [[Hailey-Hailey disease]]: autosomal dominant with painful erosions, vesicles, and crusting in the neck, axeillae, groin, and perineum |
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+ | ** [[Pemphigus vulgaris]]: autoimmune disease with flaccid bullae and painful ulcers, often including skin and mucosa |
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+ | ** [[Galli-Galli disease]]: variant of [[Dowling-Degos disease]] with hyperpigmentation and pruritis, scaly papules on trunk and proximal extremities |
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+ | == Management == |
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+ | * 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) |
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+ | * Second-line options include oral retinoids, systemic corticosteroids, and phototherapy |
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+ | == Further Reading == |
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+ | * 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: [https://doi.org/10.1111/ijd.14700 10.1111/ijd.14700]. PMID: [https://pubmed.ncbi.nlm.nih.gov/31724740/ 31724740]. |
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[[Category:Dermatology]] |
[[Category:Dermatology]] |
Latest revision as of 11:37, 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 white 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.