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Grover's Disease

  • An uncommon skin disease characterized by a rash on the trunk
  • Symptoms include an itchy rash of small, reddish spots on the chest and back
  • Treatment includes medications, phototherapy, and lifestyle changes
  • Involves dermatology

Grover's Disease

Overview

Practically everyone experiences a rash from time to time. In most cases, they are caused by common conditions such as contact dermatitis, atopic eczema, or psoriasis, among many others. Sometimes, though, a rash can be a sign of a rare disease. This is the case with Grover’s disease, a skin disorder named after Ralph Grover, the physician who first described it in 1970.

People with Grover’s disease typically develop an itchy rash on their chest and back. While it sometimes goes away on its own within a few weeks, in some patients it persists for months or years. The itching may be severe, sometimes so much so that it interferes with sleep.

Unfortunately, there is no cure for Grover’s disease. But several treatment options are available that can help, including medications, phototherapy, and lifestyle changes. These therapies can relieve symptoms, reduce the risk of flareups, and may help clear up the rash.

What is Grover's disease?

Grover’s disease is a skin disorder characterized by a rash of small, raised skin-colored or reddish spots, which are usually itchy. While the rash caused by Grover’s disease may last for just two to four weeks and then disappear, the rash can sometimes persist for months or even years. However, even after the rash goes away on its own, it often reappears, sometimes repeatedly over the course of years. 

Grover’s disease is an uncommon skin condition, though its exact prevalence—the proportion of people affected by it—is unknown. It is twice as common in men than women, and it most commonly occurs in Caucasian adults. Though it sometimes affects young people, the average age at diagnosis is 61.

What causes Grover's disease?

While the cause of Grover’s disease is unknown, patients may find that it is triggered or its symptoms are worsened by several factors:

  • Sweating
  • Heat
  • Prolonged bedrest (e.g., during hospitalization)
  • Ultraviolet light or sunlight
  • Ionizing radiation (e.g., from X-rays or CT scans)
  • Medications (e.g., some chemotherapy drugs)
  • Dry skin, especially in winter months

Grover’s disease sometimes occurs in people who have certain types of eczema, including atopic dermatitis and contact dermatitis. It is also known to affect people with other medical conditions including kidney failure, some skin and blood cancers, chronic kidney failure, and solid organ transplantation.

How is Grover's disease diagnosed?

Your doctor will begin to make a diagnosis by asking about your symptoms and when they began. They may also ask about your exposure to risk factors or whether you have or have had medical conditions that have been associated with Grover’s disease.

Your doctor will need to examine your skin visually to check for signs and symptoms of Grover’s disease. For this purpose, they will use a handheld device known as a dermatoscope or dermoscope—a specialized magnifying lens.

Often, a diagnosis can be made based on a medical history and the findings of a physical exam. Sometimes, however, a biopsy is necessary to make or confirm the diagnosis. In this procedure, a health care provider will remove a small piece of skin from the affected area. A pathologist will then examine this skin sample under a microscope to look for characteristic signs of Grover’s disease.

How is Grover's disease treated?

Several types of medications, as well as phototherapy, are used to reduce symptoms:

  • Topical corticosteroids. Steroid creams and ointments help to reduce inflammation and itching.
  • Systemic steroids. Oral corticosteroids such as prednisone may be used for patients whose symptoms do not respond well to topical steroids or who have severe symptoms.
  • Topical vitamin D. Vitamin D-containing topical medications such as calcipotriol and tacalcitol may help reduce itching and rash.
  • Oral retinoids. Oral retinoids such as isotretinoin and acitretin are typically reserved for people with severe symptoms or those whose symptoms are unresponsive to other treatments.
  • Oral antihistamines. These medications can help reduce itching. 
  • Phototherapy and photochemotherapy. Exposing affected areas of skin to specific wavelengths of ultraviolet light may reduce symptoms. In photochemotherapy, psoralens (plant-derived compounds that increase the skin’s sensitivity to UV treatment) are applied to the skin prior to UV exposure.

People with Grover’s disease may also find that over-the-counter products such as moisturizers and emollients can bring relief. Calamine lotion, zinc oxide preparations, or other anti-itch products that contain menthol or pramoxine (a topical anesthetic) can also be helpful.  

What is the outlook for people with Grover's disease?

While the course of Grover’s disease varies from one person to the next, treatment is helpful in relieving symptoms so people with the condition are able to go about their normal lives.