Grover's disease is a rare, transient skin disorder that consists of small, firm, raised red lesions, most often on the skin of the chest and back. Diagnosis of this disorder becomes apparent under microscopic examination when the loss of the "cement" that holds the skin cells together is observed. Over time, as the skin loses the "cement", the cells separate (lysis). Small blisters containing a watery liquid are present. These blisters tend to group and have a swollen red border around them. Grover's disease is mainly seen in males older than forty or fifty. Its cause is unknown but it is thought to be related to trauma to sun damaged skin.
Symptoms of Grover’s disease are small, solid, raised bumps on the skin; separation of connective tissue in the skin’s outer layers (acantholysis); and itching (pruritus). For some patients the itching may be severe. Patients with this disorder often have blisters containing a thin, watery liquid with hair follicles (recessed spots with a central hair) within the affected area. The skin eruptions are found in groups and have a swollen, red border around them. The formation of skin overgrowth (hyperkeratosis) occurs above the blisters. There is an abnormality of the horny layer of the skin resulting from a disturbance in the process by which skin cells, damaged by the environment, attach to each other.
The eruptions in Grover’s disease are usually found on the back, chest and sometimes on the sides of the extremities (arms and legs) and can last from a few weeks to many months. The disease usually recedes at its own pace (self-limiting).
The exact cause of Grover’s disease is not known. It may be related to fragility of old sun-damaged skin. Some doctors feel that this skin disorder may be related to heat and sweating. There have been multiple cases of this disorder associated with such things as hot tubs, hot water bottles, electric blankets, steam baths and prolonged confinement to a bed. This theory has not been proven. At least one case of this disorder has been associated with follicle mites which are parasites.
Grover’s disease is a rare skin disorder seen mainly in males over the age of forty or fifty. It has also been found in females.
Grover's disease may be difficult to treat in some patients. Some patients will be affected once and the condition may respond readily to standard treatments. For others, the disorder may recur several times and require long-term therapy or the use of more potent drugs. Decreased bathing and topical lubrication is usually beneficial.
The milder topical steroids and antihistamines may provide temporary relief of the itching that occurs with Grover's disease. Reports of the effectiveness of tetracycline may be found in the medical literature. The use of oral retinoids (acetretin or isotretinoin) has been reported, but these pharmaceuticals must be used with extreme care.
Topical treatment with selenium sulfide has been effective in clearing up the lesions on some patients.
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
For information about clinical trials sponsored by private sources, contact:
James WD, Berger T, Elston DM. Eds. Andrew’s Diseases of the Skin: Clinical Dermatology. 10th ed. Saunders Elsevier. Philadelphia, PA. 2006:478.
Hanson M, Hsu S. Pruritic papules on the chest and back. Grover’s disease. Am Fam Physician. 2006;74:641-42.
Scheinfeld N, Mones J. Seasonal variation of transient acantholytic dyskeratosis (Grover’s disease). J Am Acad Dermatol. 2006;55:263-68.
Tscharner GG, Buhler S, Borner M, Hunziker T. Grover’s disease induced by cetuximab. Dermatology. 2006;213:37-39.
Quirk CJ, Heenan PJ. Grover’s disease: 34 years on. Australas J Dermatol. 2004;45:83-86.
Happle R. Linear Darier’s or Grover’s disease? J Am Acad Dermatol. 2003;49:1200-01.
FROM THE INTERNET
Grover’s disease. DermNet NZ. Last updated 08 Dec 2006. 3pp.
Grover’s disease. The Doctor’s Doctor. Last Updated July 7, 2006. 14pp.
Grover’s Disease. DermIS. nd. 1p
Zabawski Jr EJ, Cockerell CJ. Transient Acantholytic Dermatosis. emedicine. Last Updated: June 8, 2005. 10pp.