doiSerbia

Grover’s disease in a patient with atopic dermatitis - a case report

Jakovljević Sanja (University of Novi Sad, Faculty of Medicine Novi Sad + Clinical Center of Vojvodina, Clinic of Dermatovenereology Diseases, Novi Sad), sanja.jakovljevic@mf.uns.ac.rs; sanjajakovljevicns
Vujanović Ljuba (University of Novi Sad, Faculty of Medicine Novi Sad + Clinical Center of Vojvodina, Clinic of Dermatovenereology Diseases, Novi Sad)
Ogorelica Dejan (University of Novi Sad, Faculty of Medicine Novi Sad + Clinical Center of Vojvodina, Clinic of Dermatovenereology Diseases, Novi Sad)
Fejsa-Levakov Aleksandra (University of Novi Sad, Faculty of Medicine Novi Sad + Clinical Center of Vojvodina, Pathology and Histology Center, Novi Sad)
Sekulić Jasmina (General Hospital ”Dr. Đorđe Joanović”, Zrenjanin)

Introduction. Grover’s disease is characterized by pruriginous polymorphic rash with a variable course and duration. Although the etiology is still unknown, the disease is often associated with other dermatoses, malignant diseases, use of certain medications, as well as immunosuppression. Case Report. We report a case of a 70-year-old male patient who was referred for examination to the Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, due to a rash that lasted for nine months. The first lesions on the skin appeared around the nipples as exudative eczematous plaques. A few months later, identical lesions appeared on the lower legs. During treatment with systemic antihistamines and topical corticosteroids, there were episodes of transient improvements and re-exacerbations. In the meantime, erythematous brownish, round and oval papules appeared on the abdomen and the back, accompanied by intense itch. Laboratory findings revealed eosinophilia and elevated serum immunoglobulin E levels. A skin biopsy of the back lesion was performed and the histopathological examination confirmed the diagnosis of Grover’s disease. After the systemic treatment using corticosteroids and antihistamines, with gradual dose reduction and application of topical corticosteroids and emollients, complete regression of the skin lesions was achieved. Conclusion. Since the clinical manifestations of the disease may be nonspecific and discrete, dermatopathological analysis is of crucial importance in making the correct diagnosis. In patients with atopy, the treatment with systemic corticosteroids, antihistamines and topical agents may lead to regression of skin lesions with a significant improvement in the quality of life.

Keywords: Dermatitis, Atopic, Acantholysis, Skin Diseases, Signs and Symptoms, Diagnosis, Morphological and Microscopic Findings, Glucocorticoids, Histamine Antagonists