Bullous transient acantholytic dermatosis

Waisman, M.

doi:10.1001/archderm.112.10.1440

Cited by 13 publications

(16 citation statements)

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“…There are also reports of clinically bullous GD corresponding microscopically to the pemphigus variant. 28 These cases cannot be considered to fit into the vesicular pattern, that in our opinion deserves distinct consideration as a peculiar microscopic expression of GD.…”

Section: Discussionmentioning

confidence: 84%

Grover Disease: A Reappraisal of Histopathological Diagnostic Criteria in 120 Cases

Fernández‐Figueras

Puig²,

Cannata³

et al. 2010

The American Journal of Dermatopathology

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Grover disease (GD) is a rather common papular pruritic dermatosis that can be transient, persistent, or asymptomatic. The microscopic diagnosis of clinically suspected lesions can be challenging because GD can adopt different patterns, and involved areas are generally admitted to be mostly focal. The histopathologic hallmark of the disease is acantholysis, frequently combined with dyskeratosis, which confers the lesions an appearance similar to Darier disease, Hailey-Hailey disease, or pemphigus. Eczematous features can be observed as well. In this study of 120 consecutive cases of GD, we have found a sex and age incidence similar to what has been previously described, with no obvious seasonal influence, but careful evaluation of their microscopic features suggests that the histopathological diagnostic criteria of GD should be expanded. Specifically, in addition to the commonly described GD findings, we have detected cases with porokeratosis-like oblique columns of parakeratosis, lesions showing a nevoid or lentiginous silhouette, intraepidermal vesicular lesions, lichenoid changes with basal vacuolization and dyskeratosis, and dysmaturative foci with keratinocyte atypia. Moreover, quite often the dermal infiltrate was composed not only of lymphocytes intermingled with eosinophils, but also of neutrophils. In many cases, the capillary vessels showed hints of vascular damage including endothelial tumefaction due to cytoplasmatic edema and erythrocyte extravasation. Finally, because involved areas were larger than 2 mm in more than 50% of our cases, we should assume that GD lesions are not always as small as commonly claimed. Awareness of the patterns newly described herein may be important to avoid underdiagnosis of GD and may contribute to understand the pathogenesis of this acantholytic disease.

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Section: Discussionmentioning

confidence: 84%

Grover Disease: A Reappraisal of Histopathological Diagnostic Criteria in 120 Cases

Fernández‐Figueras

Puig²,

Cannata³

et al. 2010

The American Journal of Dermatopathology

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“…Acantholysis may be observed in several skin or mucous membrane diseases, such as pemphigus, Darier disease, benign chronic familial pemphigus (Hailey-Hailey disease), transient acantholytic dermatosis (Grover 1970, Feinstein et al 1971, Simon et al 1976, Waisman et al 1976, Chalet et al 1977, benign papular acantholytic dermatosis (Heaphy et al 1976), focal acantholytic dyskeratosis (Ackerman 1972), viral diseases and tumors.…”

Section: Discussionmentioning

confidence: 99%

“…Electron microscopic studies of dyskeratotic varieties of this disease have been reported (Grover 1971, Grover & Duffy 1975 but not of a pemphigus vulgarislike one. All of the cases reported showed cutaneous involvement, exeept one which showed an involvement of nostril (Waisman et al, 1976), We report an electron microscopic study of a case of transient acantholytie dermatosis with oral mueosal involvement (pemphigus vulgaris-like pattern).…”

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confidence: 91%

Transient Acantholytic Dermatosis with Involvement of Oral Mucosa

Kanzaki

Hashimoto

1978

J Cutan Pathol

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Histologic, immunologic and electron microscopic studies were performed in a patient with transient acantholytic dermatosis which involved oral mucosa. Hitologic and electron microscopic findings were almost identical in both cutaneous and mucous membrane lesions, and these were similar to pemphigus vulgaris; suprabasilar separation with acantholytic cells. Desmosome-desmosome complexes were separated without disruption of cell membranes and cytoplasmic structures were well-preserved without dyskeratosis. Lamina lucida, however, was often separated in mucous membrane lesions, in contrast to the normal lamina lucida in cutaneous lesions of such cases or in pemphigus vulgaris. Direct and indirect immunofluorescence studies for pemphigus were repeatedly negative. This study shows that transient acantholytic dermatosis may involve mucous membrane and may resemble pemphigus vulgaris histologically and ultrastructurally except for the widened lamina lucida of the mucous membrane.

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“…Topical therapies, including vitamin D analogs, 20,21 retinoids, 16,22,23 lactic acid, 16 urea, 24 and corticosteroids, have been tried. 25 Photochemotherapy as well as narrowband ultraviolet B have demonstrated success; however, ironically, Grover's disease may also be exacerbated by PUVA. 26,27 Debilitating cases may require oral therapy, such as with systemic steroids.…”

Section: Nonsurgical Treatment Approachesmentioning

confidence: 99%

“…26,27 Debilitating cases may require oral therapy, such as with systemic steroids. 25,28 The treatment of other dyskeratotic conditions with vitamin A has led to its use in Grover's disease, 8 and in four patients, treatment with isotretinoin resulted in remission in three of the four patients. 29 Combination therapy, such as with low-dose acitretin and topical calcipotriene ointment, have successfully induced remission, 30 and methotrexate may also be effective.…”

Section: Nonsurgical Treatment Approachesmentioning

confidence: 99%