Transient acantholytic dermatosis
Clinically, transient acantholytic dermatosis presents with red scaly papules and papulovesicles over the trunk. The condition is usually intensely pruritic; however, some patients are completely 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. Since the condition is benign, the primary goal of treatment is control of symptoms.
L11.1 – Transient acantholytic dermatosis [Grover]
17796002 – Transient acantholytic dermatosis
- Bacterial folliculitis or Pityrosporum folliculitis – Lesions are perifollicular and pustules may be more evident.
- Acne – Younger patients with more pustules, inflammatory papules, and comedones located on the face in addition to the trunk.
- Pemphigus foliaceus – Larger erosions that may have yellow, flaky, adherent scale.
- Pemphigus vulgaris – Presents with oral mucosal involvement.
- Impetigo – Impetiginization and honey-colored crusting.
- Miliaria rubra – Distributed in areas where there has been prolonged occlusion.
- Cutaneous candidiasis – May present with pustules in areas where there has been prolonged occlusion.
- Seborrheic dermatitis – Sebaceous distribution, scaly plaques.
- Pityriasis rosea – Herald patch with papules and plaques arranged along the skin fold lines.
- Scabies – Look for burrows in characteristic locations, such as the finger web spaces and wrists.
- Darier disease – Seborrheic distribution with associated nail changes and lifelong as well as family history.
- Hailey-Hailey disease – Affects intertriginous areas of the skin, lifelong and family history.
- Arthropod assault
- Papular eczema
- Multiple lichen planus-like keratoses
- Multiple actinic keratoses
- Irritant contact dermatitis
- Pityriasis lichenoides
- Secondary syphilis