Practically everyone experiences a rash from time to time. In most cases, they are caused by common conditions such as contact dermatitis, atopic dermatitis (eczema), or psoriasis, among many others. Sometimes, though, a rash can be due to less common causes. This is the case with Grover’s disease, a skin disorder named after Ralph Grover, the physician who first described it in 1970.
People with Grover’s disease typically develop an itchy rash on their chest and/or back. While it sometimes comes and goes on its own within a few weeks, in some patients it persists for months or years. The itching may be severe, sometimes so much so that it interferes with sleep.
Unfortunately, there is no cure for Grover’s disease. But several treatment options are available that can help, including medications, phototherapy, and lifestyle changes. These therapies can relieve symptoms, reduce the risk of flareups, and may help clear up the rash.
What is Grover's disease?
Grover’s disease is a skin disorder characterized by a rash of small, raised pink spots, which are usually itchy. There may also be a small scab in the middle of the bumps. While the rash caused by Grover’s disease may last for just two to four weeks and then disappear, the rash can sometimes persist for months or even years. However, even after the rash goes away on its own, it often reappears, sometimes repeatedly over the course of years.
Grover’s disease is an uncommon skin condition, though its exact prevalence—the proportion of people affected by it—is unknown. It is twice as common in men than women, and it most commonly occurs in Caucasian adults. Though it sometimes affects young people, the average age at diagnosis is 61.
Although it is called Grover’s disease, the only known manifestation is a rash; it is not thought to be a sign of another underlying or internal medical condition.
What causes Grover's disease?
While the cause of Grover’s disease is unknown, patients may find that it is triggered or its symptoms are worsened by several factors:
- Prolonged bedrest (e.g., during hospitalization)
- Ultraviolet light or sunlight
- Ionizing radiation (e.g., from X-rays or CT scans)
- Medications (e.g., some chemotherapy drugs)
- Dry skin, especially in winter months
Grover’s disease sometimes arises in people who have certain types of eczema, including atopic dermatitis.
How is Grover's disease diagnosed?
Your doctor will begin to make a diagnosis by asking about your symptoms and when they began. They may also ask about your exposure to risk factors associated with Grover’s disease.
Your doctor will need to examine your skin visually to check for signs and symptoms of Grover’s disease. For this purpose, they may a handheld device known as a dermatoscope or dermoscope—a specialized magnifying lens.
Often, a diagnosis can be made based on a medical history and the findings of a physical exam. Sometimes, however, a skin biopsy is necessary to make or confirm the diagnosis. In this procedure, a health care provider will remove a small piece of skin from the affected area. A pathologist will then examine this skin sample under a microscope to look for characteristic signs of Grover’s disease.
How is Grover's disease treated?
Several types of medications, as well as phototherapy, are used to reduce symptoms:
- Topical corticosteroids. Steroid creams and ointments help to reduce inflammation and itching.
- Topical vitamin D. Vitamin D-related topical medications such as calcipotriene may help reduce itching and rash.
- Oral retinoids. Oral retinoids such as isotretinoin and acitretin are typically reserved for people with severe symptoms or those whose symptoms are unresponsive to other treatments.
- Oral antihistamines. These medications can help reduce itching.
- Phototherapy. Exposing affected areas of skin to specific wavelengths of ultraviolet light in a controlled setting may reduce symptoms.
- Other oral or injected medications. These medications are also typically reserved for people with severe symptoms or those whose symptoms are unresponsive to other treatments.
People with Grover’s disease may also find that over-the-counter products such as moisturizers and emollients can bring relief. Using unscented bar soap (as opposed to scented or liquid soaps/washes) may also help. Anti-itch products that contain menthol or pramoxine (a topical anesthetic) can also be helpful.
What is the outlook for people with Grover's disease?
While the course of Grover’s disease varies from one person to the next, treatment is helpful in relieving symptoms so people with the condition are able to go about their normal lives.
What makes Yale Medicine unique in its approach to Grover's disease?
“Grover’s disease can have a very negative impact on one’s quality of life, usually from the itch, which can be intense. So, we take treatment of this disease very seriously,” says Yale Medicine dermatologist William Damsky, MD, PhD. “We work with patients to develop an individualized treatment plan that they are comfortable and satisfied with. This may involve a cream, an oral medication, or even, sometimes, a highly specialized injected medication, depending on the circumstances. Our ultimate goal is to safely restore our patients’ skin health.”