Abstract
To the Editor.— In the November 1985 issue of theArchives, Hu et al1reported seven cases of transient acantholytic dermatosis (Grover's disease) and proposed that an etiologic connection existed between exposure to heat and sweating, the hypothetical escape of sweat urea from acrosyringeal structures into the surrounding epidermis, and the onset of focal acantholysis. We assumed that if this were so, other intraductal substances would also escape from the acrosyringium into the blister space and should be detectable using appropriate immunohistochemical techniques. We surveyed ten cases of transient acantholytic dermatosis with characteristic clinical and histologic findings for the presence of carcinoembryonic antigen and epithelial mucin within the blister space. Both of these substances are easily detectable within the normal acrosyringium2,3and should give an indication of disruption of the acrosyringium. Immunohistochemical methods were performed in a standard fashion using an unlabeled antibody peroxidase-antiperoxidase technique,4using a polyclonal antibody raised against carcinoembryonic antigen, and using a monoclonal antibody raised
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