Medically reviewed by Casey Gallagher, MDMedically reviewed by Casey Gallagher, MD
Transient acantholytic dermatosisalso known as Grover’s disease, is a very rare skin condition that causes a rash, sometimes severe, on the chest or back. Researchers are not sure what causes Grover’s disease. Some studies have identified certain triggers, including extreme heat, sweating, end-stage kidney failure, and a recent organ transplant.
Grover’s disease affects about 0.1% of the population and is most likely to affect older white people who were assigned male at birth. People assigned male at birth are three times more likely to be affected by Grover’s disease than people assigned female at birth.
Grover’s disease causes a rash on the chest or back that causes itching, burning, and small bumps on the skin that sometimes crust over. Symptoms appear quickly and often last about 6-12 months. Treatment is aimed at relieving the itching and usually includes topical corticosteroids and antihistamines (applied to the skin).
Symptoms of Grover’s disease
Symptoms of Grover’s disease appear rapidly over a few weeks. Common symptoms include:
-
Rash (possibly severe) on the chest or back, sometimes extending to the arms or legs
-
Severe itching (pruritus)
-
Small blisters with watery fluid
-
Red, pink or brown skin lesions
-
Blisters and lesions that crust over over time
The duration of symptoms varies. Many cases of Grover’s last 6-12 months, but many cases last longer or shorter. In some cases, symptoms resolve spontaneously without treatment.
What causes Grover’s disease?
Researchers do not know exactly what causes Grover’s. Some studies have described possible triggers that lead to the disease. However, the mechanism behind these triggers has not yet been defined.
Heat, sweat and sun
People with Grover’s often cite recent exposure to extreme heat, excessive sweating, or prolonged exposure to the sun. Some researchers believe that excessive sweating from a previously blocked sweat gland may play a role. Others believe that ultraviolet (UV) radiation from the sun causes the rash.
Other health problems
Some research suggests that other health conditions or medications cause Grover’s. For example:
-
Many studies suggest that kidney failure can cause Grover’s disease. Grover’s disease can also affect people who have recently had a kidney transplant.
-
One study showed a high level of comorbidity between Grover’s disease and cancer, meaning that they often occur at the same time. In this study, 61% of people with Grover’s disease had a history of cancer.
-
Grover’s disease can be a side effect of cancer drugs. One review identified 13 cases of drug-related Grover’s disease. All 13 cases were caused by cancer treatment.
Anecdotal triggers
Other rare reported triggers include:
Risk factors
Grover’s disease primarily affects older white males. One study assessed the demographics of 69 cases of Grover’s disease and found that 71% of those affected were male and 74% were white. Studies also show that the average age of onset is 61.
It is important to note that many of these studies have low population numbers due to the rarity of the disease and may not be representative. More studies are needed to confirm the demographics and risk factors of Grover’s disease.
Diagnosis
Grover’s is diagnosed by a primary care physician or a dermatologist (a doctor who specializes in skin, hair, and nails). Your health care provider will start by performing a physical exam and asking you when you first noticed symptoms.
If Grover’s disease is suspected, your healthcare provider may take a skin biopsy: a sample of skin from the rash to look at under a microscope. Your healthcare provider will look for acantholysis in your skin cells. Acantholysis occurs in groups of cells due to a loss of proteins that help cells stick together. Seeing acantholysis in a skin biopsy confirms the diagnosis of Grover’s disease.
Treatment of Grover’s disease
Grover’s often resolves on its own within a year. The main goals of treatment are therefore to control the itching and prevent future outbreaks.
There are no clinically approved treatments for Grover’s disease. Because of this, many of the treatments used for Grover’s disease are medications used to treat other rashes and inflammatory conditions.
Treatment for less severe cases of Grover’s disease includes:
-
Corticosteroids: Prescription strength topical (applied to the skin) creams to reduce inflammation
-
Antihistamines: Oral (taken by mouth) medications to reduce the immune response
-
Vitamin D analogues: Medicines that increase vitamin D in the body
Treatment options for more severe cases or cases that do not respond to the above treatments include:
-
Retinoids: Medicines derived from vitamin A that increase collagen and cell renewal (removing dead cells and replacing them with new ones)
-
Accutane (isotretinoin): An oral medication derived from vitamin A that is often used to treat acne
-
Tetracycline: An oral antibiotic that can help reduce inflammation
-
Systemic corticosteroids: Medicines taken orally or by injection to reduce inflammation
-
Phototherapy: Exposure to low UV radiation
-
PUVA phototherapy: Phototherapy combined with an oral drug called psoralen that increases the skin’s sensitivity to UV light
Prevention
The most effective way to prevent Grover’s is to avoid the potential triggers. In particular, try to avoid prolonged exposure to the sun or heat and use sunscreen regularly.
Related conditions
There are two conditions that go hand in hand with Grover’s disease: cancer and kidney disease.
Interestingly, data suggests that Grover’s is not only comorbid with cancer and end-stage renal disease, but also with treatments for these diseases. Because of this, researchers are unsure whether Grover’s is caused by the conditions themselves or is a side effect of their medications.
The comorbidity study found that 61% of people with Grover’s had a history of cancer. It also found that 32% of those cases were nonhematologic cancers (cancers that do not start in the blood or bone marrow). This suggests that specific types of cancer can cause Grover’s. Another interesting finding was that 62% of people with Grover’s received chemotherapy.
A quick review
Grover’s disease is a very rare skin condition that causes a rash on the chest, back, and arms. Symptoms can last 6-12 months and vary in length and severity from person to person.
Grover’s disease usually affects white males in their 60s. The cause of Grover’s disease is unknown. Studies and anecdotal reports suggest that Grover’s disease appears to be triggered by extreme heat and sweating or exposure to the sun’s UV rays. Other possible triggers include kidney failure and a history of cancer.
To diagnose Grover’s, your health care provider will perform a physical exam and evaluate a skin sample. Although there are no specific treatments for Grover’s, health care providers use many medications that are commonly prescribed for other types of rashes. Treatment may include topical corticosteroid creams, vitamin D analogs, antihistamines, and retinoids.
Frequently Asked Questions
Is Grover’s disease an autoimmune disease?
Grover’s is not an autoimmune disease. Autoimmune diseases occur when the body mistakenly attacks its own healthy cells. Grover’s appears to be triggered by environmental factors and specific health conditions.
Can medications cause Grover’s disease?
There is some documented evidence that cancer drugs cause Grover’s disease. One review identified 13 cases of drug-related Grover’s disease. All 13 cases were caused by cancer treatment.
Is Grover’s disease worse in winter?
Although researchers disagree on this, it appears that Grover’s disease is more commonly diagnosed in the winter.
Sign up for our newsletter for more Health.com news!
Read the original article on Health.com.