Pruritic papules on the trunk of a 67-year-old man

Abstract

Conflict of interest: none declared. A 67‐year‐old man presented with a 12‐month history of an intermittently intensely pruritic rash on his trunk. He had served with the armed forces in the tropics. For over 40 years he had had a keen interest in caravanning. On examination, he had numerous pinkish‐red papules concentrated in the interscapular and submammary regions with a background of chronic solar damage (Fig. 1). A punch biopsy was taken of one of the papules on the back and sent for histological examination. ... At low power (Fig. 2), histology revealed a small suprabasal blister with presence of a chronic inflammatory infiltrate in the dermis. High‐power view of the blister (Fig. 3) showed acantholysis and mild spongiosis. The overlying epidermis remained intact. ... ... What is your diagnosis? Grover's disease. Grover's disease (GD), also known as transient and persistent acantholytic dermatosis, is an acquired papulovesicular eruption of unknown origin. It was first described in 1970,1 and has subsequently been expanded to include several clinicopathological entities. Although it has been reported in people of all ages, it is most commonly seen in white men over the age of 40 years. There is a male‐to‐female ratio of 3 : 1. It appears that the older the patient is at presentation, the longer the eruption is likely to last.2