What is Grover’s Disease?

Grover’s disease is a potentially debilitating skin condition. The exact cause is unknown. However, treatments are available to manage the symptoms.

Also called transient acantholytic dermatosis, Grover’s disease typically presents as a rash on the chest and back. Intense itching often accompanies the rash.

Possible treatments include oral medications and topical creams for direct application to the skin. The most effective treatment will vary from person to person, so people with Grover’s disease will need to consult with a doctor to find what works best for them.

Symptoms of Grover’s Disease

Temporary Grover’s disease can be hard to identify, especially when symptoms begin. It usually starts as an itchy chest or an itchy spot on your back, then quickly spreads and includes the following symptoms:1

• Small, itchy red bumps that become crusted
  Blisters that contain a hair follicle and a thin, watery fluid
• Appearance of reddish, bumpy spots on the skin
• Itchiness on the skin
• Rashes all over the skin
• Heat stress
• Burning and crusting of spots
• Intense sweating
• Minor bleeding on the spots sporadically
• A rash on the neck, chest, and back
• Clumps of blisters surrounded by a swollen red ring
• Occasional appearance of rash on arms and legs
• Mild to intense itching that worsens with exposure to heat or extensive sweating, cold and dry air, and exposure to ultraviolet light
• Extreme itching that affects your quality of life

Grover’s disease usually lasts from six months to one year and is more common onset in the winter months.

Causes of Grover’s Disease

Grover’s disease occurs as a result of changes to the proteins that help to hold the skin cells together.

These changes occur at a microscopic level and cause partial breakdown of the skin. For some people, this breakdown results in Grover’s disease.

While the exact cause remains unclear, there are many possible triggers, including:

• increased sweating
• fever
• prolonged bed rest, for example during hospital stays
• extended periods of sun exposure
• dry skin, especially during the winter months
  certain medications
• organ transplants
• end-stage renal (kidney) disease and hemodialysis
• exposure to radiation, such as X-rays

Cancer, chemotherapy, and recent organ transplants can increase the risk of developing abnormal forms of Grover’s disease. In these cases, the rash may appear in an unusual location on the body after beginning on the back or chest.

Doctors tend to keep all risk factors in mind, rather than focusing on any one trigger. Dr. Friedman told MNT that Grover’s disease is likely due to a combination of elements, “including sun exposure, age, and skin care habits.

Diagnosis of Grover’s Disease

The only way to confidently diagnose Grover’s disease is to do a skin biopsy. A biopsy is a tissue sample that a doctor sends to a laboratory for testing.

Dermatologists typically use a shave skin biopsy. They will numb the area of skin, so the individual does not feel any pain, then use a razor-like tool to cut a sample from one of the rash bumps.

There is a small chance that a biopsy will leave a scar. To minimize that chance, a person should follow the doctor’s post-procedure instructions.

Sometimes people may confuse Grover’s disease with other conditions, including:

Darier disease: Unlike Grover’s disease, Darier disease usually appears during or just after puberty (before age 30) and is hereditary.
Hailey-Hailey disease: This disease involves blisters and crusted skin bumps, but is genetic.
Pemphigus foliaceus: This is an autoimmune condition. Doctors can use immunofluorescence, a staining technique that can identify pemphigus foliaceus under a microscope, to distinguish it from Grover’s disease.
Galli-Galli disease: This condition involves a rash that looks similar to Grover’s disease, but it is hereditary.
In addition to the biopsy, a doctor is likely to ask about any family history of skin conditions to help them make the correct diagnosis.

Which Foods to Eat and Avoid With Grover’s Disease

While the cause of Grover’s disease is unknown, certain foods have demonstrated therapeutic and health-promoting effects in some inflammatory skin conditions.11

Consider the following when choosing foods.

Foods with omega-3 fatty acids can have suppressive and anti-inflammatory impact.12 Foods that provide omega-3s include the following:13

• Fish and other seafood (especially coldwater fatty fish, such as mackerel, salmon, herring, tuna, and sardines)
• Nuts and seeds (such as flaxseed, chia seeds, and walnuts)
• Fortified foods (such as certain brands of eggs, yogurt, juices, milk, and soy beverages
  Plant oils (such as flaxseed oil, soybean oil, and canola oil)

Foods with Vitamin C, including the following:

• Oranges
• Peppers
• Strawberries
• Broccoli

Foods high in antioxidants, including the following:14

• Red kidney beans
• Black beans
• Leafy green vegetables
• Berries
• Eggplant
• Tomatoes
• Apples
• Dark chocolate
• Tea

Foods high in vitamin E:

• Sunflower seeds
• Spinach
• Almonds
• Peanuts
• Avocados

Avoid eating the following foods that may trigger or aggravate itchy skin. This can include the following.15

Refined sugar and refined carbohydrates often found in the following foods:

• Breads
• Sodas
• Candy
• Cookies
• Cakes
• Fruit drinks
• Yogurts

Dairy:

• Milk
• Cheese
• Ice cream
• Yogurt

Meats with nitrates or nitrites:

• Bacon
• Other processed meats, like lunch meat

Whey protein, excess coffee, fried foods, and alcohol can also trigger and aggravate the skin.

Co-Occurring Conditions in Grover’s Disease Patients

There is no known cause for Grover’s disease. However, the following conditions can co-occur with Grover’s disease or worsen its symptoms:16

• History of cancer, often with chemotherapy
• Extended bedridden condition or hospitalization
• Atopic dermatitis (eczema)
• Contact dermatitis
• Xerosis cutis (dry skin)

Since Grover’s disease typically occurs in men age 50 and over, the possibility of having multiple comorbidities (other conditions) commonly experienced in older age increases. Using drugs and therapies for other conditions can potentially complicate the effectiveness of treatment options such as steroids and retinoids.

Prevention of Grover’s Disease

Since heat and sweating may trigger Grover’s disease, doctors recommend that people who may be at risk avoid places or activities that could cause the body to heat up excessively or produce sweat.

This could include wearing moisture-wicking clothing or avoiding intense sun exposure.

Grover’s disease is not always preventable, so it is best to see a doctor as soon as any symptoms appear. Prompt diagnosis can help prevent symptoms from impacting on a person’s quality of life.

Treatment of Grover’s Disease

There is no standard treatment plan for Grover’s disease, but dermatologists and other experts have developed several lines of treatment that can help reduce symptoms.

Doctors will begin treating Grover’s disease using the first line of treatment and move onto the second or third line if symptoms do not improve.

First line:

• moisturizers, including lotions, balms, and gels
• over-the-counter (OTC) or prescription anti-itch corticosteroid cream
• oral antihistamines, which are available OTC in many forms

Second line:

• topical vitamin D analogs in a liquid or cream for topical application
• antifungal or antibiotic therapy

Third line:

• oral or injectable systemic corticosteroids, which require a prescription (oral prednisone is very common)
• oral or topical systemic retinoids, which also need a prescription
• PUVA phototherapy, which uses ultraviolet light to provide relief but can sometimes make the disease worse initially

Dr. Friedman suggests combining different treatments to get symptoms under control.

“Aggressive treatment, especially in severe cases, is needed to provide relief,” he told us. “I frequently use oral retinoids, a form of vitamin A, to treat moderate to severe cases, along with potent topical steroids and antibacterial washes.”

Self-Care Treatment for Grover’s Disease

While you are waiting for prescription medication to resolve symptoms of Grover’s disease, self-care treatments can help you avoid known triggers. To do this, take the following measures:

• Remain cool to prevent sweating.
• Avoid excessive sun exposure.
• Use mild topical steroids (hydrocortisone) or oral antihistamines (Benadryl) if the lesions are itchy.
• Keep your skin moist with a bland emollient like
• Eucerin or Cetaphil cream.
• Avoid prolonged bed rest.
• Don’t wear very tight clothing.
• Wear moisture-wicking clothing.
• Reduce stress and anxiety.

Reference:

https://www.medicalnewstoday.com/articles/321977

https://www.verywellhealth.com/grovers-disease-7495672