| • | AKA Transient Acantholytic Dermatitis |
| • | mnemonic: “TAD Grover is a sweaty middle-aged man.” |
Clinical:
| • | common; bed-ridden patients (especially with fever and sweating) |
| • | tends to appear at the end of weekends following heavy exercise (especially in hotter climates) |
| • | scattered, discrete lesions on the upper trunk |
| • | pruritic, papulo-vesicle eruption; pruritis of sudden onset |
| • | Course: self-limited, but not “transient” (may last weeks to months) |
Pathogenesis:
| • | disordered keratinization may play an important role |
| • | possibly related to excessive sweating and occlusion of sweat ducts, analogous to miliaria |
Ddx:
| • | miliari rubra, pityrosporum folliculitis, drug eruption, Darier-White disease, scabies, EPF, insect bites |
Histology:
acantholysis = characteristic epidermal change
| • | occuring in 4 main patterns (often seen combination) |
| 1. | resembling Darier-White (most common) |
| • | the best histologic evidence for diagnosis of Grover’s disease is the presence of several differrent patterns of acantholysis in the same biopsy |
Treatment:
| • | avoid heat and sweat producing activities |
| • | vitamin A 50,000 Units TID X 2 weeks, then 50,000 units QD for up to 12 weeks |
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