Bullous Grover’s Disease in a Chinese Tibetan Adolescent: A Case Report

Qiuyue Wang,1,2,* Nana Luo,1,2,* Min Lei,1,2 Xian Chen,3 Chunxiao Li,2 Pingsheng Hao2 1School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Department of Dermatology, Hospital of Chengdu University of Traditional Chine...

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Main Authors: Wang Q, Luo N, Lei M, Chen X, Li C, Hao P
Format: Article
Language:English
Published: Dove Medical Press 2022-07-01
Series:Clinical, Cosmetic and Investigational Dermatology
Subjects:
Online Access:https://www.dovepress.com/bullous-grovers-disease-in-a-chinese-tibetan-adolescent-a-case-report-peer-reviewed-fulltext-article-CCID
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author Wang Q
Luo N
Lei M
Chen X
Li C
Hao P
author_facet Wang Q
Luo N
Lei M
Chen X
Li C
Hao P
author_sort Wang Q
collection DOAJ
description Qiuyue Wang,1,2,* Nana Luo,1,2,* Min Lei,1,2 Xian Chen,3 Chunxiao Li,2 Pingsheng Hao2 1School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 3Department of Pathology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chunxiao Li; Pingsheng Hao, Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu 610075, Sichuan, People’s Republic of China, Tel +86-18981937829 ; +86-13881965024, Fax +86-028-87732407, Email chunxiaolee@126.com; hpswl@126.comAbstract: Grover’s disease (GD), also known as Transient acantholytic dermatosis, has no typical clinical rash features. It usually occurs in elderly white men but very rarely in China. This is a disease of acantholysis and dyskeratosis, which is usually considered to be spontaneous remission. The skin lesions of the disease are diverse, and the main symptom is severe itching. We have reported a case of GD in a 14-year-old Chinese Tibetan male whose clinical manifestations were pruritic red papule, generalized red papules, papulo vesicles and blisters ranging from millet rice to soybean size. Skin lesions change rapidly and variously. In order to confirm the diagnosis, we have done skin biopsies, immunofluorescence, dermoscopy, microscopy and other examinations. Pathological skin biopsy showed acantholysis. Intraepidermal blisters and the presence of blisters on the basal cells as well as under the stratum corneum can be observed on the same pathological section. Type IV collagen immunohistochemistry showed blisters in the epidermis. The diagnosis of GD depended on the exclusion of other diseases. After we performed whole exon sequencing (WES) on DNA from the patient’s blood, pathogenic gene mutations were not found. Pustular psoriasis, Subcorneal pustular dermatosis, Herpesvirus infections, Dermatitis herpetiformis, Pemphigus vulgaris, Norwegian scabies, Darier’s disease, and Hailey-Hailey disease were all excluded. We successfully treated adolescent GD with minocycline combined with methotrexate. The patient was followed up for 19 months without recurrence.Keywords: Grover’s disease, Chinese, minocycline, methotrexate, adolescent, case report
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spelling doaj.art-677ee89c36bc4eab855a2b23dd3a72932022-12-22T01:29:47ZengDove Medical PressClinical, Cosmetic and Investigational Dermatology1178-70152022-07-01Volume 151371137676634Bullous Grover’s Disease in a Chinese Tibetan Adolescent: A Case ReportWang QLuo NLei MChen XLi CHao PQiuyue Wang,1,2,* Nana Luo,1,2,* Min Lei,1,2 Xian Chen,3 Chunxiao Li,2 Pingsheng Hao2 1School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 3Department of Pathology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chunxiao Li; Pingsheng Hao, Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu 610075, Sichuan, People’s Republic of China, Tel +86-18981937829 ; +86-13881965024, Fax +86-028-87732407, Email chunxiaolee@126.com; hpswl@126.comAbstract: Grover’s disease (GD), also known as Transient acantholytic dermatosis, has no typical clinical rash features. It usually occurs in elderly white men but very rarely in China. This is a disease of acantholysis and dyskeratosis, which is usually considered to be spontaneous remission. The skin lesions of the disease are diverse, and the main symptom is severe itching. We have reported a case of GD in a 14-year-old Chinese Tibetan male whose clinical manifestations were pruritic red papule, generalized red papules, papulo vesicles and blisters ranging from millet rice to soybean size. Skin lesions change rapidly and variously. In order to confirm the diagnosis, we have done skin biopsies, immunofluorescence, dermoscopy, microscopy and other examinations. Pathological skin biopsy showed acantholysis. Intraepidermal blisters and the presence of blisters on the basal cells as well as under the stratum corneum can be observed on the same pathological section. Type IV collagen immunohistochemistry showed blisters in the epidermis. The diagnosis of GD depended on the exclusion of other diseases. After we performed whole exon sequencing (WES) on DNA from the patient’s blood, pathogenic gene mutations were not found. Pustular psoriasis, Subcorneal pustular dermatosis, Herpesvirus infections, Dermatitis herpetiformis, Pemphigus vulgaris, Norwegian scabies, Darier’s disease, and Hailey-Hailey disease were all excluded. We successfully treated adolescent GD with minocycline combined with methotrexate. The patient was followed up for 19 months without recurrence.Keywords: Grover’s disease, Chinese, minocycline, methotrexate, adolescent, case reporthttps://www.dovepress.com/bullous-grovers-disease-in-a-chinese-tibetan-adolescent-a-case-report-peer-reviewed-fulltext-article-CCIDgrover’s diseasechineseminocyclinemethotrexateadolescentcase report
spellingShingle Wang Q
Luo N
Lei M
Chen X
Li C
Hao P
Bullous Grover’s Disease in a Chinese Tibetan Adolescent: A Case Report
Clinical, Cosmetic and Investigational Dermatology
grover’s disease
chinese
minocycline
methotrexate
adolescent
case report
title Bullous Grover’s Disease in a Chinese Tibetan Adolescent: A Case Report
title_full Bullous Grover’s Disease in a Chinese Tibetan Adolescent: A Case Report
title_fullStr Bullous Grover’s Disease in a Chinese Tibetan Adolescent: A Case Report
title_full_unstemmed Bullous Grover’s Disease in a Chinese Tibetan Adolescent: A Case Report
title_short Bullous Grover’s Disease in a Chinese Tibetan Adolescent: A Case Report
title_sort bullous grover rsquo s disease in a chinese tibetan adolescent a case report
topic grover’s disease
chinese
minocycline
methotrexate
adolescent
case report
url https://www.dovepress.com/bullous-grovers-disease-in-a-chinese-tibetan-adolescent-a-case-report-peer-reviewed-fulltext-article-CCID
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