Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1997. Updated February 2016.
Transient acantholytic dermatosis causes a truncal rash characterised by acantholysis on histopathology. It can be transient, as the name suggests, 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.
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:
The cause of transient acantholytic dermatosis is unknown. Sometimes, it follows sweating or some unexpected heat stress, so there has been 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.
Transient acantholytic dermatosis often starts quite suddenly. It is more common in winter than in summer. Characteristics include:
The plaques start on the chest and back, and may spread to affect other areas of the body.
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.
Disorders that may appear similar to transient acantholytic dermatosis are:
There is no curative treatment for transient acantholytic dermatosis, but the following suggestions may be helpful.
Keep cool. Wear garments designed to prevent sweat rash.
The duration of transient acantholytic dermatosis is variable—from days to decades, when it is known as persistent acantholytic dermatosis. It can come and go, often with a seasonal variation.
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