Morbus Grover

Transient acantholytic dermatosis

Grover’s disease is a benign papular skin disease characterised histologically by acantholysis. Grover’s disease is mainly seen in older, fair-skinned males, of the sebostatic skin type. Suspected triggers include local irritations, sunlight, xerosis, increased sweating and heat.

Skin disorders usually heal within weeks to months; sometimes it can however take years to clear up. Disseminated, succulent, non-confluent papules and occasionally even papulovesicles with keratotic or partly crusty surfaces can be found on the chest, neck and upper back. Itching can be severe.

Histological Diagnosis

In a histological examination you can see a circumscribed acantholysis with suprabasal or subcorneal gap formations, often accompanied by a spongiosis and a dyskeratosis. They can be categorised into different types, which resemble 4 other skin diseases (Darier disease, Spongiotic Dermatitis, Hailey-Hailey disease and Pemphigus).

Dermatoscopic Diagnosis

Disseminated, single reddish-yellowish papules and papulovesicles partly with hyperceratosis occur primarily on the trunk. In dermatoscopy hyperceratosis can be recognised well due to the whitish, yellowish firmly attached scale. One look through the dermatoscope is often enough to differentiate between other itching skin diseases, such as exsiccation eczema that also occurs often in older men.

Therapy

Locally you can use nourishing lotions, such as Lotio alba. Short-term treatment with creams containing cortisone may also be considered.

Additionally, an internal therapy with antihistamines over a period of 1 to 2 weeks has proven to be successful. Agonising pruritus is treated with PUVA therapy or UVB/UVA light therapy. Glucocorticosteroids are available systemically.

There are also reports about therapy attempts with vitamin A acid derivatives such as Isotretinoin in therapy-resistant cases.

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