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Other papulonodular disorders
Published in Aimilios Lallas, Enzo Errichetti, Dimitrios Ioannides, Dermoscopy in General Dermatology, 2018
Enzo Errichetti, Aimilios Lallas, Dimitrios Ioannides
Grover’s disease is an acquired uncommon disorder typically involving fair-skinned people aged over 40 years that may be triggered by factors promoting sweating (e.g., febrile illnesses or occlusion) or skin dryness6; it may show different histological patterns, viz. Darier like, spongiotic, pemphigus foliaceus like, pemphigus vulgaris like, and Hailey–Hailey like, with the first two being the most frequent.6,7
The Histopathology of Eczema
Published in Donald Rudikoff, Steven R. Cohen, Noah Scheinfeld, Atopic Dermatitis and Eczematous Disorders, 2014
Cynthia M. Magro, A. Neil Crowson, Molly E. Dyrsen, Martin C. Mihm
Grover disease was originally defined as a transient, self-limited, acantholytic process that typically affects the front and back of the chest, with occasional lesions on the back or thighs of middle-aged to elderly males. In some cases it may be quite persistent. The cause is not known, but it is included in the consideration of spongiotic dermatitis because multiple forms of acantholysis may be seen in this entity, including spongiotic acantholysis. There appears to be an association with UV light exposure, because eruptions or exacerbations of lesions have occurred after prolonged sun exposure, vacationing in a sunny area, and sunburn from a sunlamp. Grover disease has been considered a reaction to excessive heat and sweating, and associated with ionizing radiation. The medications sulfadoxine-pyrimethamine and recombinant human IL-4 have also been implicated in the development of Grover disease. Oral lesions are rare, as are vesicles and bullae (Parsons 1996). In consequence, the differential diagnosis is that of ‘itchy red bump disease,’ namely pityrosporum folliculitis, and insect-bite reactions.
Photoaggravated Dermatoses
Published in Henry W. Lim, Herbert Hönigsmann, John L. M. Hawk, Photodermatology, 2007
Victoria P. Werth, Herbert Hönigsmann
Grover’s disease is a nonimmune acantholytic dermatosis. The etiology and pathogenesis of Grover’s disease is unknown. Factors that can trigger the disease include sweat, fever, heat, and sunlight. Some reports have hypothesized causation by poral occlusion of damaged eccrine intra-epidermal ducts, with spillage of sweat contents and focal acantholysis (9). Acantholysis is often not associated with the eccrine duct outflow tract. Different studies have shown the primary damage in the proteins of the desmosomal attachment plaque, such as desmoplakins I and II and plakoglobin (10,11).
A novel report of nivolumab-induced transient and persistent acantholytic dermatosis associated with multiple cutaneous toxicities in a patient with metastatic melanoma
Published in Acta Oncologica, 2022
Yana Kost, Daiva M. Mattis, Bijal Amin, Daniel E. Sammartino, Beth N. McLellan
Immune checkpoint inhibitors (ICIs), a class of cancer therapeutics that promote antitumor immune responses through T-cell activation, are becoming standard therapy for an increasing number of advanced malignancies [1]. However, approximately half of patients experience immune-related adverse events (irAEs) with ICI use and the skin is one of the most commonly affected organs [1]. Toxicities can result in therapy discontinuation leading to worse cancer treatment outcomes [1]. Transient and persistent acantholytic dyskeratosis or Grover disease (GD) is a benign pruritic dermatosis characterized by discrete pruritic papules or papulovesicles most commonly located on the trunk and proximal extremities [2]. The condition predominantly occurs in white middle-age or elderly males and often resolves spontaneously, but may have a chronic course [2]. GD has been described as a rare irAE associated with ipilimumab in three reported cases [3–5]. Our patient presented with irAEs secondary to nivolumab which has been shown to have a lower incidence of irAEs compared to ipilimumab [6]. To our knowledge this is the first report of GD in association with nivolumab therapy in a patient with multiple cutaneous toxicities related to treatment.
Cutaneous adverse events of immune checkpoint inhibitor therapy: incidence and types of reactive dermatoses
Published in Journal of Dermatological Treatment, 2022
Thomas K. Le, Subuhi Kaul, Laura C. Cappelli, Jarushka Naidoo, Yevgeniy R. Semenov, Shawn G. Kwatra
Of the 1857 patients treated with anti-PD-1 ICIs, there were 1079 patients treated with nivolumab, 821 patients treated with pembrolizumab, and 43 patients treated with both pembrolizumab and nivolumab. There were 254/1857 (13.7%) patients who developed one of the 28 different dermatoses identified from the literature review following anti-PD-1 ICIs. Eleven reactions, although reported in the literature, had an incidence n < 5: xerosis (n = 4), Stevens-Johnson syndrome (n = 2), paronychia (n = 2), panniculitis (n = 2), onycholysis (n = 2), maculopapular eruption (n = 2), bullous pemphigoid (n = 2), alopecia areata (n = 2), acral erythema (n = 2), Grover’s disease (n = 2), and erythema multiforme (n = 2), as reported in Table S1. 6 reactions had an incidence of n = 0. This included dermatomyositis, erythroderma/pityriasis rubra pilaris, granuloma annulare, hyperkeratosis, photosensitivity, and subacute cutaneous lupus erythematosus (Table S1).
The safety and efficacy of dabrafenib and trametinib for the treatment of melanoma
Published in Expert Opinion on Drug Safety, 2018
Sarah Knispel, Lisa Zimmer, Theodora Kanaki, Selma Ugurel, Dirk Schadendorf, Elisabeth Livingstone
Both dabrafenib and trametinib can induce a wide range of cutaneous AEs which are mostly mild in severity. In clinical trials, different exanthematous skin reactions were often summarized under the term of ‘rash.’ Differentiation of these skin reactions will help to better understand the nature but also the treatment of the respective condition. Dabrafenib frequently causes a macular-papular drug-related exanthema (Figure 2), which often develops within the first weeks of treatment. Another and even more common exanthematous skin reaction induced by BRAF-inhibition is Grover’s disease [52]. The histopathologic examination of biopsies from affected skin often shows dyskeratosis and acantholysis [53,55]. Additionally, Darier’s-like disease that on histology looked similar to Grover’s disease has been reported [55].