What is the treatment for Grover's disease?

Treatment for Grover's Disease

The first-line treatment for Grover's disease includes topical corticosteroids (medium to high-potency) and antihistamines for symptomatic relief of pruritus. 1, 2

First-Line Treatment Options

• Topical corticosteroids are the most frequently employed treatment with a response rate of approximately 70% 2
• Medium to high-potency topical steroid formulations should be used on the body, while low-potency hydrocortisone should be used for facial lesions to avoid skin atrophy 3
• Topical vitamin D analogues can be used as adjunctive therapy 1
• Antihistamines should be prescribed for symptomatic relief of itching 1, 2
• Moisturizing emollients can help manage symptoms and may contribute to spontaneous resolution 4

For Persistent or Severe Disease

• Systemic retinoids have shown a high response rate of approximately 86% for refractory cases 2
• Systemic corticosteroids may be considered for widespread or severe disease with a response rate of about 64% 2
• Phototherapy (PUVA) can be effective for resistant cases 4
• Methotrexate may be considered for cases resistant to other therapies 4

Disease Course and Prognosis

• Spontaneous resolution within one week to eight months occurs in approximately 42% of cases 2
• The disease can follow three patterns: persistently pruritic, transient eruptive, or a chronic asymptomatic course 4
• Some cases may persist for years, particularly in patients with certain risk factors 4

Risk Factors and Triggers to Address

• Heat and sweating should be avoided as they can trigger or exacerbate the condition 1, 5
• Cool and dry air can also trigger the disease, which is four times more likely to be diagnosed in winter months 4
• Ultraviolet radiation may exacerbate the condition and should be avoided 4
• Occlusive dressings or bandages can precipitate the disease in predisposed individuals 5
• Other associated triggers include renal failure, malignancy, and certain medications 1

Special Considerations

• In immunocompromised patients (e.g., transplant recipients), the disease may present differently and require careful monitoring 4
• For patients with localized or unusual distribution patterns, consider the possibility of genetic factors or environmental triggers 5
• The disease is more prevalent in middle-aged Caucasian men with a male-to-female ratio of approximately 3.95 2

Treatment Algorithm

1. Confirm diagnosis through clinical presentation and histology if necessary
2. Start with topical corticosteroids and antihistamines for symptomatic relief 1, 2
3. If no improvement after 4 weeks, consider adding topical vitamin D analogues 1
4. For persistent or severe cases, consider systemic therapy with retinoids or corticosteroids 2
5. For refractory cases, consider phototherapy or methotrexate 4
6. Advise patients to avoid known triggers such as heat, sweating, and UV exposure 1, 4