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Grover’s disease

What is Grover’s disease?

Grover’s disease is a skin condition in which small but firm red lesions appear on the chest and the back area. In the medical world, it is also known as Transient Acantholytic Dermatosis, Benign Papular Acantholytic Dermatosis or Persistent Acantholytic Dermatosis. The main characteristics of this disease, speaking from a dermatological point of view are: polymorphism, itchiness and presence of papulovesicular lesions. Speaking from a histological point of view, this disease presents acantholysis (loss of intercellular connections) and rarely dyskeratosis.


This is a medical condition that affects the male population and especially over fifty years of age. It is less commonly found in the female population or in younger people and its appearance seems to be influence by the immune status (more often found in people with compromised immune systems) and seasons (more common in winter). After the diagnosis, the transient type takes from six to twelve months to heal but there are certain types (persistent) for which the healing period if considerably longer.

What does Grover’s disease look like?

At a first glance, one will notice small, red and bumpy spots on the skin. These will appear most often on the central part of the back and the chest but they can also be encountered on the sternum, arms and even thighs. If the disease is complicated by a case of dermatitis, then the small spots are surrounded by larger plaques, the latter extending to other parts of the body.

The spots that appear on the skin in Grover’s disease are actually small blisters that are filled with watery liquid. These have the tendency to appear grouped in an area and they seem red actually due to the swollen red border that is around them. Under a microscopic examination, Grover’s disease becomes clear, as one can notice the loss of intercellular connections that was already mentioned above. Basically, the glue holding the cells of the skin together is falling apart.

Symptoms of Grover’s disease

These are the most common symptoms of Grover’s disease:

  • Skin lesions that can be blistered, crusted or eroded
  • Frequent itchiness
  • Slight bleeding (occasional)
  • Extended rash and plaques (in case of complicated dermatitis)

Grover’s disease Causes

The exact causes that lead to the appearance of Grover’s disease have yet to be identified. Below, you will find a list of triggers and risk factors that may contribute to the appearance of the lesions on the skin.

  • Unexpected heat stress
  • Sweating
  • Occlusion
  • Traveling to tropical or semitropical climates (accompanied by fever)
  • Weak immune system – HIV, leukemia, bone marrow transplants
  • Extensive sun exposure
  • Xerosis (dry skin)
  • Medication – sulfadoxine-pyrimethamine, anastrozole, ribavirin, vemurafenib, cetuximab, dabrafenib, interleukin-4, mercury, D-penicillamine
  • Ionizing radiation
  • End-stage renal disease
  • Hemodialysis
  • Mechanical irritation
  • Extended bed rest
  • Pyoderma gangrenosum
  • Bacterial and viral infections
  • Cancer

Treatment

First of all, you should know that in the situation the patient does not present pruritus, treatment might not be required. For the other cases, the treatment for the Grover’s disease is often topical but there are also other treatment solutions you can try out. These are the most common courses of treatment when it comes to Grover’s disease:

Anti-sweating powder

This is indeed one of the most helpful things that you can consider, especially if you are the kind who sweats a lot. In the case of Grover’s disease, the more you sweat, the more pruritus will appear and you will suffer. Luckily, the itchiness becomes lower in intensity once the sweating is also reduced.

Steroids

When it comes to steroids, you have two possibilities. The first is represented by the topical treatments containing steroids such as hydrocortisone. These are often presented under the form of a cream or ointment and they can be really helpful when it comes to relieving itching. Steroid creams can be applied two times a day in order to be effective. Topical applications have to be made until the skin is practically irritated, as this is the only way to eliminate the lesions. This is also the reason why you might see your skin shedding off at a superficial level after a treatment with steroid creams. On the other hand, in case of more serious pruritus, the second choice is represented by cortisone injections.

Anti-itchiness creams

While the solution presented above reduces the pruritus, you can use other creams in order to obtain an even more calming effect. These topical creams usually contain substances such as menthol or camphor, moisturizing the skin and reducing the sweating level down to a minimum. Using these creams, you will feel like your skin has finally calmed down. However, keep in mind that this is only temporary relief and you have other treatments available to pursue. Keep in mind that a thick cream will rather occlude the lesions than heal them, so an emollient cream might be recommended.

A special anti-itching cream is the one containing zinc oxide, talc and glycerol. Not only does this cream helps when it comes to the upsetting pruritus but it can also guarantee faster healing of the skin lesions.

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Calcipotriol cream – this cream contains a derivative of vitamin D and it is often used for the treatment of psoriasis. However, as it was mentioned, Grover’s disease can be complicated by a case of dermatitis and, in such situations, this cream is the perfect adjutant that you need.

Antifungal medication

A small number of people get Grover’s disease after a fungal infection, hence the need for the oral medication.

Photo-therapy

This should only be taken as a course of treatment only in certain cases, as sometimes it can make matters worse. In many patients, however, at first it seems that it has exacerbated the disease, only to clear it afterward.

Experimental oral retinoids

Recommended only for serious cases, as they have a lot of side effects. Plus, these have to be taken on a regular basis and even after the lesions have subsided, you will still have to take a low dose in order to induce remission.

Occlusion with a sauna suit

This can help the medication therapy to work better but there is always the risk of sweating and over-heating that must be taken into consideration.

Antihistamines – these can help with the control of the itchiness as well.

How long does it last?

In the majority of the cases, Grover’s disease maintains its transient characteristic and it lasts somewhere from six to twelve months. There are many patients in which it appears and disappears, somehow having a seasonal variation (commonly comes in the cold season and goes away with the coming of warmer temperatures but not hot ones). In some patients, despite its name, it may not be transient and actually persist for a longer period of time, for years maybe. The itchy eruption will remain the primary feature but if you notice a failure to improve with the above mentioned treatment, you and your doctor should consider the existence of an additional infection in the body. Three of the most common culprits in such situations are scabies, Staphylococcus aureus and herpes simplex.

Is Grover’s disease contagious?

Even though this is a skin condition that is almost always accompanied by excessive pruritus, you should not worry. Grover’s disease is not contagious and it cannot be given to a person who comes in contact with the lesions.

Natural remedies for Grover’s disease

There are several natural remedies you can consider for Grover’s disease:

  • Coconut oil – you apply it two or three times a day, after showering and it will certainly help with the itch
  • Marshmallow root and papaya leaf – these herbs are perfect for itchiness reduction as well
  • Borage oil – this is recommended to be taken orally, helping with the itchiness
  • A mix of olive oil and sea salt
  • Oatmeal bathing
  • Apple cider vinegar spraying
  • Natural anti-itchiness cream – sea salt, baking soda, bentonite clay, witch hazel
  • Turmeric powder mixed with milk or honey
  • Olive leaf extract or soap
  • Aloe Vera oil
  • Drinking carrot juice – it contains a lot of vitamin A which is very good for the skin
  • Fresh cilantro – helps in cases where mercury is the primary culprit.

Grover’s disease Pictures

Collection of pictures of Grover’s disease…

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