Grover disease: review of subtypes with a focus on management options.

Grover disease (GD) is a benign eruption that causes a papulovesicular rash on the trunk and proximal extremities. It often resolves spontaneously but can follow a more chronic and fluctuating course that may last several years. Although the etiology remains unknown, several associated triggers have been identified including heat and sweating, cool and dry air, renal failure, malignancy, and the initiation of several drugs. Since the disease tends to resolve on its own, management is aimed at disease prevention and symptomatic relief. First-line therapy includes topical steroids and vitamin D analogues with adjuvant antihistamines. In more severe cases that are refractory to less aggressive therapy, systemic corticosteroids, retinoids, and phototherapy may lead to successful resolution. Novel therapies are few and have little evidence but involve innovative use of light therapy and immune modulators. Herein, we review the literature and new trends of GD with a focus on established and novel treatments.

Enfermedad de Grover, una patología ampollar poco frecuente: a propósito de 2 casos / Grover's disease, a pathology blistering unusual: About 2 cases

Grover's disease (GD) or transient acantholytic dermatosis, is a papulovesicular pruritic disease of unknown etiology. It´s most important histopathological finding is the presence of focal acantholysis. The incidence has not been firmly established. Case report: We report two cases of papulovesicular rashes, the first one in a 79 year old man with good response to second line treatment and the second one, in a 30 year old woman. Both with different suspected triggering factors. Comment: GD predominates in white men with an average age of presentation of 61. Clinically, it presents as erythematous papules, crusted-papule and is usually pruritic. The etiopathology is still unknown, but it is associated with triggers such as: ultraviolet radiation (UVR), ionizing radiation, heat, sweat, friction and chemotherapy. Acantholysis is the classic histological finding. Management includes general measures, topical corticosteroids, calcineurin inhibitors, tretinoin, calcipotriene and antihistamines. In refractory cases, second-line treatment is used: oral isotretinoin, systemic corticosteroids and phototherapy. Paradoxically, phototherapy can also trigger GD. Conclusions: Due to the low prevalence of GD in Chile, 2 new cases are provided to the literature. In both cases, the diagnostic presumption was based on an exhaustive clinical history, confirmed by histopathological findings. (AU)

Enfermedad de Hailey-Hailey recalcitrante con buena respuesta a terapia fotodinámica / Refractory Hailey-Hailey Disease That Responded Well to Photodynamic Therapy

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Pruritic erythematous maculopapular rash.

A trip to the beach left this patient with an unusual rash where his bathing suit had been.

[Grover's disease following hemodialysis in a patient with renal failure]. / Morbus Grover unter Hämodialy--setherapie bei Niereninsuffizienz.

A 54-year-old woman with polycystic renal disease and renal failure developed Grover's disease while undergoing renal dialysis. Grover's disease or transitory acantholytic dermatosis is characterized by intensely pruritic, hyperkeratotic, succulent papules and plaques located on the trunk. The pathogenesis is unknown; genetic factors and actinic damage have been implicated. Medications, heat or immunosuppression can worsen the disease. Associations with atopic dermatitis, contact dermatitis and asteatotic dermatitis have also been described. Differential diagnostic considerations include folliculitis, scabies and dermatitis herpetiformis. Therapeutic options include moisturizing agents and phototherapy, as well as topical and systemic retinoids. There are only few case reports in the literature describing Grover's disease occurring during hemodialysis treatment. All such previous patients have been men; ours is the first woman.