Grover’s disease is a rare, temporary skin disorder. Also termed as transient acantholytic dermatosis or persistent acantholytic dermatosis, it causes small, red spots on the skin. Most people suffering from the condition have red, raised spots that are sometimes extremely itchy.
Symptoms and Diagnosis
Grover’s disease manifests in the form of a skin rash or blistery spots found mostly on the chest or back. The disorder often leads to intense itching. Most cases continue for around six to twelve months, with some cases persisting for longer periods occasionally.
The most commonly found symptom of this skin disease is small, raised bumps that are firm or solid. You may also observe the presence of blisters, with a red border and a watery liquid. These blisters and bumps may appear in groups on the back, neck, and chest. The appearance of the rash is usually sudden.
This skin disease affects the outermost layer of the skin. It manifests in four different patterns, some of which are similar to those found in other disorders. The tombstone-shaped pattern is the most commonly found, followed by Darier, Hailey-Hailey, and spongiotic patterns.
If you have a rash of this kind, your doctor will first examine you. This disorder can be diagnosed by a dermatologist. Sometimes, it is difficult to differentiate between Grover’s and other skin disorders. In such cases, diagnosis can be confirmed through a skin biopsy.
The disease occurs most commonly in men aged 50 and above. According to dermatologists, people with Grover’s have an abnormal outermost layer of skin, called the horny layer. This affects how the skin cells connect to each other. A consequent detachment of skin cells, or lysis, leads to the formation of blisters or bumps. The exact cause of this skin disease is unknown; however, doctors have identified certain contributing factors. The factors mentioned below are suspected to either cause the disorder or worsen symptoms.
- End-stage renal disease or kidney failure
- Organ transplant
- Prolonged bed rest
- Heat and sweating
- Exposure to ionizing radiation like X-rays, sun, or microwaves
Certain cases of the disorder have also been associated with a few medications including biologic agents like anastrozole and antiviral medicines like ribavirin. The disease is also found in patients suffering from atopic dermatitis or contact dermatitis. Medical professionals also think this disease may occur due to extreme temperature swings or sun damage over the years. There have also been cases associated with steam baths, hot tubs, and hot water bottles. One recorded case of this disease has been associated with skin parasites.
Treating this disease is difficult at times. While there is no cure for Grover’s disease, treatment is based on the patient’s symptoms. Individuals are usually advised to avoid exposure to the sun and strenuous exercise as sweating and heat may worsen symptoms like itching. Doctors also recommend fewer baths to alleviate symptoms.
If your symptoms are mild, you may be given the following treatments first.
- Oral antihistamines
- Anti-itch lotions with camphor or menthol
- A prescription cortisone cream for the rash
If your symptoms are severe, you may be asked to take an antibiotic or retinoids. If your symptoms are stubborn and recur, you may require long-term treatment. Light therapy is known to provide relief along with medications. You will be asked to take psoralen pills, making your skin more sensitive to UV light. Therapy is usually given two or three times a week for up to 12 weeks.
Other options for severe cases may include antifungal pills, cortisone shots, antifungal lotions like selenium sulfide, and systemic retinoid.
Certain disorders may show symptoms similar to those observed in Grover’s disease. Darier disease, for example, is a progressive skin disorder. This disorder presents in the form of papules on the face, scalp, forehead, neck, back, and behind the ears. The papules or spots become darker and larger with brown scales. The disease causes itching and burning of the spots and gradually worsens with emotional stress and exposure to the sun. Another skin disorder, dermatitis herpetiformis, is an uncommon disease. It causes a formation of clustered blisters on elbows, knees, skull, buttocks, face, and neck, with severe itching and burning. In Pemphigus, a group of rare skin disorders, blisters are found on the outer layer and within mucous membranes of the skin. The type of pemphigus determines the location of blisters on the skin. An understanding of these disorders helps to differentiate and diagnose Grover’s disease.
As mentioned earlier, avoiding triggers is one of the most effective ways to stay away from the worse symptoms of this disease. You would need to identify the factors that cause discomfort in order to avoid them. In the case of patients who develop Grover’s in the hospital, symptoms may resolve once mobility is restored. In the case of patients with recurring symptoms, avoiding sunlight and heat may prevent flare-ups.