ReportSeasonal variation of transient acantholytic dyskeratosis (Grover's disease)
Section snippets
Material and methods
A computerized search was performed to identify all patients in whom the diagnoses “transient acantholytic dermatosis,” “Grover's disease,” or “focal acantholytic dyskeratosis” were present in the pathology report, that is, in the clinical diagnosis, the histopathologic diagnosis, and/or a note appended to the histopathologic diagnosis, at the Ackerman Academy of Dermatopathology in New York City from July 1, 1999 through June 30, 2004. Of 423,106 patients we identified 660 patients with GD. We
Results
A total of 385 patients (255 men and 130 women [a sex ratio of 1.95:1; Table I]) with GD were identified. Three hundred sixty-eight patients (95.8%) lived in the northeastern United States and 17 lived elsewhere. We noted that GD occurred 4 times more often during the winter months (ie, January, February, March) than in the summer months (ie, June, July, August) (Fig 6). The percentage of GD biopsies as a percentage of total biopsies was highest in the winter, again by 4 to 5 times (Fig 7). In
Discussion
GD was first described in 6 patients by Ralph Grover in 1970. In 3 patients, he linked causally a sun induced Koebner phenomenon to transient acantholytic dermatosis. In 1984, Grover and Rosenbaum performed a retrospective study of 375 patients with GD. They noted that GD was most common in men older than 60 years of age and found a statistically significant association with atopic, asteatotic, or allergic contact dermatitis.7, 8 In 311 of 375 patients, Grover and Rosenbaum compiled the month
Conclusion
Our review suggested a relationship between GD and aged xerotic skin exposed to cold, dry winter air. Sun damage, radiation damage,36 and superficial skin infection similarly impaired epidermal integrity and provided settings conducive to the development of GD. Although the exact factors behind GD have yet to be fully defined, sweating and heat probably do not play a major role in its origin.
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Funding sources: None.
Conflicts of interest: None identified.