Grover’s Disease

Grover’s disease (GD) is also referred to as transient acantholytic dermatosis. The cause of GD is not exactly known, but may be associated with eczema, dry skin, sweating, ultraviolet radiation, and occlusion (i.e. clothing). GD has also been found to occur in association with other conditions such as chronic kidney disease. Microscopically, GD demonstrates a lack of cohesion between the cells of the epidermis (top-most layer of the skin), a process termed acantholysis. GD is a benign condition, but may be quite itchy and irritating.

Presentation:
GD is found mostly in men older than 60 years of age, presenting with numerous itchy, red, scaly bumps on the chest, shoulders, and upper abdomen. Lesions may even begin as tiny blisters, which then become scaly. Cases of GD tend to become more pronounced, during the winter months.

Treatment:
GD is most commonly treated with topical corticosteroid creams and moisturizers. Other therapies include ultraviolet light therapy, isotretinoin (an agent used for acne), and systemic (oral) corticosteroids. In addition, control of sweating and sun avoidance may provide improvement.

References:
Casanova JM, Pujol RM, Taberner R et al. Grover’s disease in patients with chronic renal failure receiving hemodialysis: Clinicopathologic review of 4 cases. J Am Acad Dermatol 1999;41:1029-33.
James WD, Berger TG, and Elston DM. “Chronic Blistering Dermatoses.” Andrews’ Diseases of the Skin. 10th Ed. Saunders:Canada, 2006, 459-78.
Scheinfeld N and Mones J. Seasonal variation of transient acantholytic dyskeratosis (Grover’s disease). J Am Acad Dermatol 2006;55:263-8.

Matthew Smetanick, D.O.
Department of Dermatology
Philadelphia College of Osteopathic Medicine/Frankford Hospital
Philadelphia, Pennsylvania.