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Transient acantholytic dermatosis
Other Resources UpToDate PubMed

Transient acantholytic dermatosis

Contributors: Ruth X. Wang MD, PhD, Elizabeth B. Wallace MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Transient acantholytic dermatosis, also known as Grover disease, is an acquired skin disorder of unknown etiology. The disease has been diagnosed in 0.1%-0.8% of the total population and is found primarily in White men aged 30 and older; the male-to-female ratio ranges from 1.8-7:1 in the literature. Although the cause has not been established, the condition has been linked to heat, sweating, excessive sun exposure, ionizing radiation, and some medications, including immunotherapies such as BRAF inhibitors, sulfadoxine-pyrimethamine, recombinant IL-4, ipilimumab, and other immune checkpoint inhibitors.
One large retrospective study of outpatients found the disease diagnosed 4 times more often in the winter than in the summer and attributed this difference to dry skin. Another study of inpatients found prolonged bed rest as a risk factor. Atopic dermatitis, renal failure (acute, chronic), transplantation, and malignancies have also been associated with this diagnosis.

Clinically, transient acantholytic dermatosis presents with red scaly papules and papulovesicles over the trunk. The condition is usually intensely pruritic; however, some individuals are asymptomatic. Flares of disease may be marked by an increase in both pruritus and surrounding erythema, vesicles, and erosions. This appearance is frequently encountered on the backs of hospitalized patients on prolonged bed rest.

This condition is histologically variable, and the key finding on pathology is focal acantholysis. The disease can be self-resolving or may wax and wane for several years, and cases of persistent disease have been reported. Since the condition is benign, the primary goal of treatment is control of symptoms.

Codes

ICD10CM:
L11.1 – Transient acantholytic dermatosis [Grover]

SNOMEDCT:
17796002 – Transient acantholytic dermatosis

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Last Reviewed:11/01/2022
Last Updated:11/08/2022
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Transient acantholytic dermatosis
A medical illustration showing key findings of Transient acantholytic dermatosis : Back, Primarily truncal distribution, Pruritus
Clinical image of Transient acantholytic dermatosis - imageId=398692. Click to open in gallery.  caption: 'Scattered light pink papules on the upper back.'
Scattered light pink papules on the upper back.
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