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Grover’s Disease / Transient Acantholytic Dermatosis

Key Points

  • Grover’s disease is a pruritic condition that typically affects adult individuals and classically presents on the trunk and proximal extremities.
  • The characteristic lesion is a crusted erythematous papule, pustule, or papulovesicle.
  • Grover’s may be triggered by heat, sweating, and occlusion and may persist for years. Sun damage and xerosis may be important risk factors.
  • The strategy is to suppress the pruritus and if possible clear the cutaneous lesions. Gentle skin care and frequent emollient use may prevent recurrences.
  • Certain medications have been reported in association with Grover’s disease.

Introduction

Grover’s disease, also known as transient acantholytic dermatosis (TAD), is a common pruritic condition that typically affects adult individuals and classically presents on the trunk and proximal extremities. It may be more common in Caucasian individuals, especially in the fifth to seventh decades of life. The characteristic lesion is a crusted erythematous papule, pustule, or papulovesicle. Lesions of transient acantholytic dermatosis (TAD) often are not “transient,” and may persist for years, especially in the inframammary regions. Heat, sweating, and occlusion appear to be triggers, with patients presenting after trips to tropical or semitropical climates, with fever, and after hospitalization or bed rest. Immunosuppression may increase the risk of developing TAD, as it is seen in patients with HIV infection, in leukemia, and in patients recently receiving bone marrow transplants. History of extensive sun exposure and xerosis may also be important risk factors. Pruritus may be severe. The strategy is to suppress the pruritus and if possible to clear the cutaneous lesions. Gentle skin care and frequent emollient use may prevent recurrences.

Certain medications have been reported in association with Grover’s disease: anastrozole, vemurafenib, dabrafenib, cetuximab, mercury, D-penicillamine.