Grover's disease (transient and persistent acantholytic dermatosis)
- Helge Riemann, MD
Helge Riemann, MD
- Mid Coast Dermatology, Brunswick, Maine
- Whitney A High, MD
Whitney A High, MD
- Associate Professor of Dermatology and Dermatopathology
- University of Colorado School of Medicine
- Section Editor
- Robert P Dellavalle, MD, PhD, MSPH
Robert P Dellavalle, MD, PhD, MSPH
- Section Editor — General Dermatology
- Professor of Dermatology and Public Health
- University of Colorado School of Medicine
- Colorado School of Public Health
- Chief, Dermatology Service
- US Department of Veterans Affairs
- Eastern Colorado Health Care System
In 1970, Ralph Grover presented a series of six patients with a pruritic papular and/or papulovesicular rash upon the trunk that cleared within weeks . Histopathologic analysis revealed a characteristic pattern of acantholysis within the epidermis, and Grover named the disease "transient acantholytic dermatosis." Subsequent reports described an often chronic course, but essentially identical histologic findings, and the term "transient and persistent acantholytic dermatosis" was proposed [2,3]. However, the eponym, "Grover's disease," remains in wide use.
The prevalence and incidence of Grover's disease have not been firmly established. In a study from Switzerland, Grover's disease was diagnosed in just 24 of more than 30,000 skin biopsies .
It is thought that Grover's disease affects chiefly white adults in the fifth decade or later and appears to be approximately 1.6 to 2.1 times more common in men than in women [5,6]. Grover's disease appears less common in darker-skinned individuals but has been reported .
The etiology of Grover's disease is unknown. Suspected triggers of disease activity include heat and sweating, sunlight, ionizing irradiation, end-stage renal disease/hemodialysis, mechanical irritation or prolonged bedrest, and solid organ transplantation [7-10].
Some cases of Grover's disease have been associated with medications, such as sulfadoxine-pyrimethamine, ribavirin, anastrozole, interleukin-4, cetuximab, and BRAF inhibitors, such as vemurafenib and dabrafenib [1,11-20]. (See "Cutaneous complications of molecularly targeted therapy and other biologic agents used for cancer therapy", section on 'Vemurafenib and dabrafenib'.)
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- Simon RS, Bloom D, Ackerman AB. Persistent acantholytic dermatosis. A variant of transient acantholytic dermatosis (Grover disease). Arch Dermatol 1976; 112:1429.
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- Ippoliti G, Paulli M, Lucioni M, et al. Grover's Disease after Heart Transplantation: A Case Report. Case Rep Transplant 2012; 2012:126592.
- Zhu HJ, Clark LN, Deloney LA, McDonald JE. Grover disease (transient acantholytic dermatosis) in acute myeloid leukemia on FDG PET/CT. Clin Nucl Med 2014; 39:e173.
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- 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.
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- Antunes I, Azevedo F, Mesquita-Guimarães J, et al. Grover's disease secondary to ribavirin. Br J Dermatol 2000; 142:1257.
- Mahler SJ, De Villez RL, Pulitzer DR. Transient acantholytic dermatosis induced by recombinant human interleukin 4. J Am Acad Dermatol 1993; 29:206.
- Tscharner GG, Bühler S, Borner M, Hunziker T. Grover's disease induced by cetuximab. Dermatology 2006; 213:37.
- Carlos G, Anforth R, Clements A, et al. Cutaneous Toxic Effects of BRAF Inhibitors Alone and in Combination With MEK Inhibitors for Metastatic Melanoma. JAMA Dermatol 2015; 151:1103.
- Anforth R, Fernandez-Peñas P, Long GV. Cutaneous toxicities of RAF inhibitors. Lancet Oncol 2013; 14:e11.
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- Powell J, Sakuntabhai A, James M, et al. Grover's disease, despite histological similarity to Darier's disease, does not share an abnormality in the ATP2A2 gene. Br J Dermatol 2000; 143:658.
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- Helfman RJ. Grover's disease treated with isotretinoin. Report of four cases. J Am Acad Dermatol 1985; 12:981.
- Breuckmann F, Appelhans C, Altmeyer P, Kreuter A. Medium-dose ultraviolet A1 phototherapy in transient acantholytic dermatosis (Grover's disease). J Am Acad Dermatol 2005; 52:169.
- Paul BS, Arndt KA. Response of transient acantholytic dermatosis to photochemotherapy. Arch Dermatol 1984; 120:121.
- Liu S, Letada PR. Successful novel treatment of recalcitrant transient acantholytic dermatosis (Grover disease) using red light 5-aminolevulinic acid photodynamic therapy. Dermatol Surg 2013; 39:960.
- Norman R, Chau V. Use of etanercept in treating pruritus and preventing new lesions in Grover disease. J Am Acad Dermatol 2011; 64:796.