From the Research
Calcipotriene is a viable treatment option for Grover's disease, as evidenced by a case report where an 84-year-old man showed significant clinical improvement after a three-week course of calcipotriol ointment 1.
Treatment Approach
When considering treatment for Grover's disease, it's essential to prioritize approaches that minimize morbidity, mortality, and improve quality of life.
- The use of calcipotriene, a vitamin D analog, has been shown to normalize keratinocyte differentiation and proliferation, addressing the abnormal keratinization seen in Grover's disease 1.
- Topical corticosteroids are also a common treatment option, with a response rate of 70% as reported in a systematic review 2.
- The treatment regimen for calcipotriene typically involves applying 0.005% ointment or cream to affected areas twice daily for 4-8 weeks.
- Potential side effects of calcipotriene include local irritation, burning, or erythema, which can be managed by reducing application to once daily or temporarily discontinuing use.
Combination Therapy
For extensive disease, combining calcipotriene with topical corticosteroids may be beneficial, using corticosteroids in the morning and calcipotriene in the evening to maximize efficacy while minimizing steroid-related side effects.
- This approach allows for the anti-inflammatory properties of corticosteroids to be utilized while leveraging the keratinocyte normalization effects of calcipotriene.
Disease Management
Given the potential for Grover's disease to follow a chronic and fluctuating course, management should focus on disease prevention and symptomatic relief, as outlined in a review of the disease's subtypes and management options 3.
- Identifying and addressing associated triggers, such as heat and sweating, cool and dry air, renal failure, malignancy, and certain drugs, is also crucial in managing the disease.