Review Grover disease: review of subtypes with a focus on management options Paola C. Aldana 1 , BS and Amor Khachemoune 2,3 , MD, FAAD, FACMS 1 School of Medicine, University of Maryland, Baltimore, MD, USA, 2 Veterans Affairs Medical Center, Brooklyn, NY, USA, and 3 Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA Correspondence Amor Khachemoune, MD, FAAD, FACMS Veterans Affairs Hospital and SUNY Downstate Dermatology Service 800 Poly Place Brooklyn, NY 11209 USA E-mail: amorkh@gmail.com Funding: None. Conflict of interest: None. Paola C. Aldana takes responsibility for the integrity of the work as a whole, from inception to published article. doi: 10.1111/ijd.14700 Abstract Grover disease (GD) is a benign eruption that causes a papulovesicular rash on the trunk and proximal extremities. It often resolves spontaneously but can follow a more chronic and fluctuating course that may last several years. Although the etiology remains unknown, several associated triggers have been identified including heat and sweating, cool and dry air, renal failure, malignancy, and the initiation of several drugs. Since the disease tends to resolve on its own, management is aimed at disease prevention and symptomatic relief. First-line therapy includes topical steroids and vitamin D analogues with adjuvant antihistamines. In more severe cases that are refractory to less aggressive therapy, systemic corticosteroids, retinoids, and phototherapy may lead to successful resolution. Novel therapies are few and have little evidence but involve innovative use of light therapy and immune modulators. Herein, we review the literature and new trends of GD with a focus on established and novel treatments. Historical evolution of our understanding of Grover disease Grover disease was first described in 1970 as a self-limited eruption of pruritic, discrete, and edematous papules and vesi- cles which appeared on the trunk and extremities following non- specific irritation. These lesions occurred in six patients without family history of skin disease and had a duration of a few weeks up to several months. Cytology of the lesions revealed focal acantholysis within the epidermis and varying levels of dysker- atosis that resembled changes seen in Darier and Hailey–Hailey disease. 1 At the time, Grover reported that only systemic corti- costeroids could be used to treat the intense pruritus caused by the disease and because of its self-limited, transient nature, he called it “transient acantholytic dermatosis.” 2 Later in 1976, Simon et al. paid tribute to Grover’s discovery of the disease by becoming the first to refer to it as “Grover disease.” 2 Since then, many clinical and histological observations have been made to better define the disease. The notion that it fol- lows a transient course has been challenged as there have been multiple cases of persistent disease, in which lesions and pruritus last several years with little response to therapy. There- fore, some authors have proposed the term “persistent acan- tholytic dermatosis.” 2 In 1977, Chalet et al. established the important clinicopathologic subtypes of the disease by describ- ing four distinct histological patterns: (i) Darier-like in which there is a focal, acantholytic dyskeratosis resembling Darier dis- ease, (ii) Pemphigus vulgaris (PV)-like involving few acan- tholytic cells over suprabasilar clefts, (iii) Hailey–Hailey-like involving numerous acantholytic cells over suprabasilar clefts, and (iv) Spongiotic in which acantholytic cells are present within spongiotic foci. 3 Through the years, several more histologic sub- types have been described and continue to expand the classifi- cation of the disease. Since the average duration of eruption is reported between 2 and 4 weeks, 4 both terms “transient acantholytic dermatosis” and “Grover disease” may be used today. However, “Grover disease” is the more conventionally used term and may be more appropriate since the disease has shown persistence as well as various morphologies other than acantholysis. Since there is a wide variation in its duration and it is well known that the disease can adopt different patterns, this review will refer to ª 2019 The International Society of Dermatology International Journal of Dermatology 2019 1