Grover's Disease

Dear Doctor,

I would like your opinion regarding Grover's disease.  I am a female in her late 30's who was diagnosed with Grover's this past winter.  The rash usually comes and goes within 24hours and my doctor was lucky to get a biopsy from it to find out what it was. There is not much information about Grover's disease.  I will explain the chain of events that have happened and would like to know what further tests you would investigate if any.  I have an undiagnosed sensory neuropathy for 2.5 yrs now, I was diagnosed with MG in 02/00, and keratoconjunctivitis a couple of months ago.  All the blood work they have performed have been negative except for the achr antibodies.  The MG assay that they performed was done at Mayo, and it came back with a high level of modulation antibodies 94% which usually indicates a thymoma.  So far, there has been no detection of a thymoma through the cat scan.  In the past testings from the neurologist, they have noticed my total protein dropping about a point a yr ex: 7.1, 6.4, and then 5.5 last fall. Also, the carbohydrate deficiency transferrin test they ran in the motor/sensory blood panel showed 3.7% with a norm under 6%.  I have been told by a lab specialist that in neuromuscular disorders this figure is surpressed and that it is usually higher than what it has presented.  I do not drink alcohol. The only thing that I have found on Grover's disease shows that it is associated with several diseases and there are uncertainties regarding association with T-cells and B-cells.  I have an appointment with a GI doc in about a month to see if that is what is causing my total protein to fall.  The neurologists don't know why.  Someone told me that the total protein loss could be from liver/kidney damage.  Can you see any association with the Grover's disease diagnosis and the rest of the information that I gave to you to be indicative of something that you have seen in the past? If so, what tests might you suggest having done. The dermatologist told me that he has seen only one other lady with Grover's disease in his life and he is about 75 yrs old.  I would appreciate any information that you have.

Thank you for reading my long winded post and for providing this forum.

[Alan Rockoff, MD]

Allison:

Your note is filled with information unfamiliar to me.  I am skeptical of the diagnosis of Grover's Disease, which as you most  likely know from reading is a condition affecting primarily middle-aged males.  it is usually not associated with systemic disease.  While the biopsy report may have shown changes consistent with Grover's Disease, the overall clinical context has to match up too, and it sounds as though it doesn't.  To interpret all the serum findings, I need to refer you toa neurologist.  I cannot think of a skin condition whose presence would shed much light on your problem.

Sorry I can't be more helpful.

best.

Dr. Rockoff

[Mary]

I recently had surgery and following that have experienced a raised itchy scaley rash.  I went in for a punch biopsy of one of the lesions on my back and it revealed Grovers disease.  I am female and 40.  Not your typical candidate, but suffer still the same.  I am wondering if there is some systemic connection as well.

[teree]

Re:  Grover's Disease - Comment

The first time I was diagnosed with Grover's disease I was 35 yrs old - it was on my body. I was diagnosed again with Grover's disease on my face and neck in January 2000, both times I had a biopsy.  I was told by one dermatologist that you can't get it on you face.

[Marysgirl]

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