The Enigma of Grover's Disease
The Enigma of Grover’s Disease
Dave Jobes, Ph.D.
If you are a white male aged 35-55 (less often in women), and start to develop a rash on your chest and/or back, don’t panic! You might just be developing something called Grover’s Disease (known more formally as ‘transient acantholytic dermatosis’). The condition was first described by Dr. Ralph Grover in 1970 and if you’d like to read a nice technical/medical review of the condition, I’d suggest this paper.
First and foremost, Grover’s Disease is not a life threatening condition but can be terribly annoying, as the red, rashy, scaly skin can be irritating and cause you to itch considerably. With a name like ‘transient’ you would think it would be short lived, but unfortunately that is not always the case. While same people may resolve the issue in 6-12 months, others will experience it on and off for years.
What is the cause of Grover’s Disease?
No one knows the exact cause but a history of significant sun exposure, heavy sweating, heat and excessive dry skin seem to contribute. To varying degrees, we all experience these types of conditions so what causes some people to tip into Grover’s Disease while others don’t is still a medical mystery.
There are some reported cases of Grover’s developing on people who are hospitalized and spend a considerable time on their backs, which bolsters the notion that heat, sweating and the other aforementioned conditions are prime drivers. Many of these hospitalized patients will completely resolve so the name ‘transient’ certainly applies here!
Finally, there is some evidence to suggest immunosuppressed individuals are more predisposed to Grover’s as it is seen in HIV/AIDS patients, leukemia patients, individuals who have undergone bone marrow transplants and patients who have received organ transplants and are on anti-rejection medication. Clearly this is a complex disease!
Is there a cure for Grover’s Disease?
While there is no cure for the condition, there are a range of effective over the counter and prescription medications that are available, including lotions, ointments and oral therapies. The one that works best for me is a synthetic corticosteroid called triamcinolone acetonide (a prescription), which is a thick, white cream that you can apply directly to the affected areas. You can also try OTC hydrocortisone and/or benadryl but I’ve noticed those don’t work as well for me, and take longer than triamcinolone. In cases where the creams and lotions don’t work, a licensed dermatologist might try phototherapy (light therapy) that uses different wavelengths of UV light directly on the affected areas. Exposure to this kind of light can exacerbate the problem so be sure you are working with a dermatologist who can monitor the situation...never try at home by yourself!
Is there a way to prevent Grover’s Disease?
Since we don’t know the exact cause, no one can say for sure how to prevent it. The prevailing ideas though are that reducing excessive exposure to the sun (i.e., don’t repeatedly allow yourself to get sunburned), keeping your skin soft and moisturized, and limiting exposure to substances that could excessively dry your skin are all useful means of reducing your chances of acquiring Grover’s Disease. I have recently switched exclusively to all natural and organic skin care products, which does seem to lessen the outbreaks, so for me at least, that helps.