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Transient acantholytic dermatosis

Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1997. Updated February 2016.

Transient acantholytic dermatosis — codes and concepts

What is transient acantholytic dermatosis?

Transient acantholytic dermatosis causes an itchy truncal rash characterised by acantholysis on histopathology. It is an acquired acantholytic dermatosis, in contrast to the rare and persistent inherited acantholytic dermatoses, Darier disease and Hailey-Hailey disease.

Transient acantholytic dermatosis is also known as Grover disease.

Who gets transient acantholytic dermatosis?

Transient acantholytic dermatosis most often affects men over 50. It is less common in women or younger people. It is common in those who are unwell in some way but can arise in quite healthy people as well. It has been reported in association with several medications, including:

  • Anastrozole
  • Vemurafenib
  • Dabrafenib
  • Cetuximab
  • Mercury
  • D-penicillamine.

What causes transient acantholytic dermatosis?

The cause of transient acantholytic dermatosis is unknown. Sometimes, it follows sweating or some unexpected heat stress, so there has been a suspicion that it may relate to sweat or sweat ducts. But it also may arise in quite dry skin. Many affected individuals are sun damaged.

What are the clinical features of transient acantholytic dermatosis?

Transient acantholytic dermatosis often starts quite suddenly. It is more common in winter than in summer. Characteristics include:

  • The most common sites are central back, mid chest.
  • Lesions are small red, crusted or eroded papules.
  • There may be vesicles and non-follicular pustules.
  • Lesions may bleed.
  • Although frequently intensely itchy, transient acantholytic dermatosis may cause no symptoms
  • So-called 'transient' acantholytic dermatosis can often prove persistent (chronic).
Transient acantholytic dermatosis

See more images of transient acantholytic dermatosis.

What are the complications of transient acantholytic dermatosis?

Transient acantholytic dermatosis may be complicated by the development of dermatitis, usually in a discoid pattern with round or oval, dry or crusted plaques.

The plaques start on the chest and back and may spread to affect the limbs.

How is transient acantholytic dermatosis diagnosed?

Transient acantholytic dermatosis is usually diagnosed clinically, but a skin biopsy may be necessary.

The pathology of transient acantholytic dermatosis is characteristic, with acantholysis (separated skin cells) with or without dyskeratosis (abnormal rounded skin cells). Spongiotic dermatitis may also be noted.

What is the differential diagnosis for transient acantholytic dermatosis?

Disorders that may appear similar to transient acantholytic dermatosis are:

What is the treatment of transient acantholytic dermatosis?

There is no curative treatment for transient acantholytic dermatosis, but the following suggestions may be helpful.

How can transient acantholytic dermatosis be prevented?

Keep cool. Wear garments designed to prevent sweat rash.

What is the outlook for transient acantholytic dermatosis?

The duration of transient acantholytic dermatosis is variable — from days to decades. It can come and go, often with a seasonal variation. 

See smartphone apps to check your skin.
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