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Top Ten Facts about Pathology of Grover's Disease

Dr Sampurna Roy MD   

 

Grover's Disease [Pathology Infographic]

 

                                                                                                                      

 

(1) Grover's disease was described for the first time by Dr RW Grover in 1970.

 

(2) It is a transient acantholytic dermatosis of unknown cause, presents as small, discrete sometimes crusted, erythematous papules and papulovesicles that is usually located on the anterior chest and abdomen and sometimes on proximal extremities.

 

(3) Groverís disease, also known as transient acantholytic dermatosis, generally occurs among elderly men (male-to-female ratio 2.4:1, mean age at diagnosis 61 years) with an incidence of 0.8 % in the hospital setting.

 

(4) The pruritus and papulovesicular rash can be exacerbated by exercise, heat, sweating and ultraviolet light exposure.

 

(5) It has been associated with numerous disorders, including hematologic malignancies, chronic renal failure, and HIV infection, as well as with chemotherapy and bone marrow and/or kidney transplant.

 

(6) Histologically, small, circumscribed foci of suprabasal acantholysis are found.

 

(7) The presence of scattered dyskeratotic cells, spongiosis and the level of acantholysis has been used to differentiate a Darier-like, spongiotic, Hailey-Hailey-like, Pemphigus-foliaceus-like, Pemphigus-vulgaris-like and mixed pattern.

 

(8)  Some authors suggested that the histopathological diagnostic criteria of Grover's disease should be expanded as cases have been reported with additional features of porokeratosis-like oblique columns of parakeratosis, lesions showing a nevoid or lentiginous silhouette, intraepidermal vesicular lesions, lichenoid changes with basal vacuolization and dyskeratosis.

 

(9)  Although Groverís disease is generally self-limited and resolves within weeks or months even in immunocompromised patients (transient acantholytic dermatosis), in some cases it may persist for several years or recur.

 

(10) This disease is clinically and histologically indistinguishable from Darier's disease and Hailey-Hailey disease, although no mutation in the ATP2A2 gene has been detected.

 

Source:

 

Ippoliti G, Paulli M, Lucioni M, DíArmini AM, Lauriola M, Mahrous Haleem Saaleb R. Groverís Disease after Heart Transplantation: A Case Report. Case Reports in Transplantation. 2012;2012:126592.

 

Koelzer VH, Buser T, Willi N, et al. Groverís-like drug eruption in a patient with metastatic melanoma under ipilimumab therapy. Journal for Immunotherapy of Cancer. 2016;4:47.

 

Moon H-R, Lee J-H, Rhee D-Y, et al. Groverís Disease in a Liver Transplant Patient. Annals of Dermatology. 2014;26(1):117-118.

 

FernŠndez-Figueras MT, Puig L, Cannata P et al. Am J Dermatopathol. 2010 Aug;32(6):541-9. Grover disease: a reappraisal of histopathological diagnostic criteria in 120 cases.

 

 

 

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