Transient acantholytic dermatosis: Difference between revisions
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*[http://www.aafp.org/afp//AFPprinter/20060815/photo.html Pruritic Papules on the Chest and Back]. [[American Family Physician]]. August 15, 2006. |
*[http://www.aafp.org/afp//AFPprinter/20060815/photo.html Pruritic Papules on the Chest and Back]. [[American Family Physician]]. August 15, 2006. |
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Revision as of 16:37, 29 May 2009
 | This article needs additional citations for verification. (February 2009) |
| Transient acantholytic dermatosis | |
|---|---|
| Specialty | Dermatology  |
Grover's disease (also known as transient acantholytic dermatosis) is a polymorphic, pruritic, papulovesicular dermatosis characterized histologically by acantholysis.[1]: 529
Symptoms
Grover's disease often starts quite suddenly. It results in very itchy spots on the central back, mid chest and occasionally elsewhere. Frequently, it follows sweating or some unexpected heat stress.
Symptoms of Grover's disease are characterized by an itchy eruption that may last an average of 10–12 months. It is characterized by papules and papulovesicles with excoriations occurring on the chest, back, lower sternum, arms, and thighs[2]. Grover's Disease is mainly seen in males over the age of forty[3] and the papules are found on the mid chest most often.
Sometimes the features of Grover's are found in people who do not itch or have a conspicuous rash. Most of the people with Grover's who visit a dermatologist, however, itch a lot.
Diagnosis
Grover's may be suspected by its appearance, but since it has such a characteristic appearance under the microscope a shave skin or punch biopsy is often performed. Once confirmed, most cases of Grover's disease last six to twelve months (which is why it was originally called "transient"). Unfortunately it may last much longer.
Treatment
The most important thing about Grover's disease treatment is to remain cool, as further sweating will induce more itchy spots. However, lesions aggravated by sweat usually return to "normal" fairly quickly; avoiding sweat is not a reason not to exercise. Minor outbreaks can be controlled with prescription strength topical cortisone creams. More troubling eruptions usually clear up after taking Accutane or Tetracycline pills for one to three months. If these fail or the outbreak is severe, PUVA phototherapy treatments, antifungal pills and cortisone injections are alternatives[4].
A further treatment option is a cream consisting Zinc Oxide, Talc, Glycerol. It is available over the counter in France branded as Aloplastine. The cream helps with the itching and promotes faster healing.
Sometimes, Grover's disease can be complicated by the development of dermatitis. The cause of Grover's is unknown, but it also may arise in quite dry skin. Many affected individuals are sun damaged[5].
Some research has correlated damage to the basement membrane and mercury toxicity with Grover's disease.[6] Damage to the basement membrane might be from sun damage, age, or other factors. Mercury in the body causes the cellular reaction that we know as Grover's disease. The recommended treatment explained in this article is with Chemet. After treatment, subsequent flaring may be caused by the release of mercury stored deeper in the body or from mercury that comes into the body from our environment. Both require the patient to be vigilant about maintaining an internal environment that is as free as possible from mercury.
References
- ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0071380760.
- ^ Grover's Disease
- ^ Grover's Disease
- ^ Grover's Disease
- ^ Grover's Disease Symptoms - Grover's Disease Treatment
- ^ Paul I Dantzig, MD with the Department of Dermatology at Columbia University School of Medicine, "Age-Related Macular Degeneration and Cutaneous Signs of Mercury Toxicity", Cutaneous and Ocular Toxicology, 24: 3-9, 2005.
External links
- Pruritic Papules on the Chest and Back. American Family Physician. August 15, 2006.