Darier's Vs. Grover's

[cdstoll]

I am a 27 year old female.  I had this rash for the first time when I was 19 years old.  SInce then the rash is appearing more frequently.  There is not known history of this rash in my family, except for my grandfather who had a rash in the head.

I was diagnosed with Darier's disease about 18 months ago.

THe symptoms:  Red rash in my chest, and in the back.  Most of the rash is on the left side of my body.  I went to the doctor when it turned into blisters, and they did a biopsy that came back with the following description:  "The surface is focally crusted and overlies an irregularyly acanthotic epidermis. Rare corps ronds and grains are seen. There is suprabasilar achantholysis in focal areas.  These changes are those of an acantholytic process and would be compatible with a diagnosis of darier's disease if it fits the clinical picture. Included in the differential diagnosis is also the possibility of grover's disease".  

Now the rash in my chest is not going away, and I have a rash in my back for about a month now that is getting worse.  I had it in my neck for about two weeks (left side of my neck). I also get it behind my knee in the left leg and also in my left arm.  This is just getting worse, and after the itchiness now it has a burning sensation.  They told me to use a topical lotion called luxiq.  When I apply it it burns, and then the itchiness comes back immediately.  It is getting to be very uncomfortable to have it in my neck and back, since I need to hide it when I go to work because it looks very bad. Is there something that I could take to make it better?  

Is this Grover's or Darier's?  I have some pictures of the rash that my husband took with the digital camera. I was first diagnosed with herpes zorces, then with Darier's or Grover's  

Please let me know if seeing the pictures of the rash will help a final diagnosis, and a possible treatment.

Thank you.

[Alan Rockoff, MD]

Darier's Disease is familial.  Grover's Disease occires mainly in adult males.



Biopsy reports have to be correlated with the clinical picture.  For the reasons in my first sentence (and others), your picture doesn't fit either diagnosis very well.  You may have a form of eczema with an unusual appearance.



Would it be out of line to wonder why you haven't asked this question of the doctor who saw you in person, performed the biopsy, and prescribed treatment?  Wouldn't he or she be the best one to correlate your symptoms with your biopsy?



Luxiq is a cortisone prepeartion.  If that doesn't work, there are lots of others worth trying.



If for some reason you are not comfortable asking the doctor you already saw, I urge you to get another opinion.  It really isn't helpful--and may indeed be counterproductive--to try interpreting your own biopsy results.



Best.



Dr. Rockoff