ABSTRACT
Grover's disease (GD) or transient acantholytic dermatosis, is a papulovesicular pruritic disease of unknown etiology. It´s most important histopathological finding is the presence of focal acantholysis. The incidence has not been firmly established. Case report: We report two cases of papulovesicular rashes, the first one in a 79 year old man with good response to second line treatment and the second one, in a 30 year old woman. Both with different suspected triggering factors. Comment: GD predominates in white men with an average age of presentation of 61. Clinically, it presents as erythematous papules, crusted-papule and is usually pruritic. The etiopathology is still unknown, but it is associated with triggers such as: ultraviolet radiation (UVR), ionizing radiation, heat, sweat, friction and chemotherapy. Acantholysis is the classic histological finding. Management includes general measures, topical corticosteroids, calcineurin inhibitors, tretinoin, calcipotriene and antihistamines. In refractory cases, second-line treatment is used: oral isotretinoin, systemic corticosteroids and phototherapy. Paradoxically, phototherapy can also trigger GD. Conclusions: Due to the low prevalence of GD in Chile, 2 new cases are provided to the literature. In both cases, the diagnostic presumption was based on an exhaustive clinical history, confirmed by histopathological findings. (AU)
Subject(s)
Humans , Male , Female , Adult , Aged , Acantholysis/diagnosis , Acantholysis/physiopathology , Acantholysis/therapyABSTRACT
Se presenta el caso de una paciente de 64 años que ha tenido episodios recurrentes de lesiones vesiculosas en su extremidad inferior derecha, diagnosticándose una dermatosis acantolítica. Existe un espectro de enfermedades acantolíticas que histopatológicamente presentan acantolisis, pero que no comparten factores genéticos. El diagnóstico clínico puede ser extremadamente difícil y es la suma de herencia, clínica, histopatología y evolución, la que permite llegar a un diagnóstico. Se realiza una reseña de todas estas enfermedades.
We present the case of 64-year-old female patient with recurrent episodes of vesicles in her lower right limb. Histopathological study revealed acantholytic dermatosis. There is a large spectrum of acantholytic dermatosis that histopathologically presents acantholysis but does not share genetic factors. Clinical diagnosis may be extremely difficult and results in the sum of genetics, clinical findings, histopathological studies and evolution. We also present a review of these diseases.