TRANSIENT ACANTHOLYTIC DERMATOSIS (GROVER'S DISEASE), KERATOSIS FOLLICULARIS (DARIER'S DISEASE), ETC.
Hypergranulosis which can be so severe that nuclei are obscured, dyskeratosis of a particular type, and suprabasal splitting are present in varying degrees in lesions that fall into several different clinical settings:
 
CLINICAL DIAGNOSIS
Multiple pruritic papules, mostly on the trunk, middle age onset, no family history. Grover's disease (transient or not-so transient acantholytic dermatosis)
Keratotic lesions plus nail dystrophy and positive family history of same Darier's disease
Solitary keratotic lesion Acantholytic acanthoma
Linear or zosteriform lesions Acantholytic dyskeratotic epidermal nevus
Incidental finding with no clinically apparent lesion Focal acantholytic dyskeratosis
The same type of pathology is seen in warty dyskeratomas which are more vertically oriented or follicular.

 
Low power view of a biopsy from a pruritic eruption on the trunk without a positive family history. Hypergranulosis is the most prominent feature in this case.
Another low power view of another area in the same biopsy. Minimal suprabasal splitting and hypergranulosis are seen in this area.
In view of the clinical history and pathology, this would be Grover's disease. Some cases of 'transient acantholytic dermatosis' are not so transient.

 
Low power view from another case having the same clinical features as above. Acantholysis is more prominent in this case, and there are hyperkeratosis and parakeratosis.
High power view of above showing suprabasal split, acantholysis, and hypergranulosis.
Another high power view of this lesion.
In view of the clinical presentation and pathology, this would also be a case of transient (or not-so-transient) acantholytic dermatosis (Grover's disease).

 
Scan view of unusual example of Grover's disease that is prominently vesicular.
Low power of above.
High power of above showing corp rond (arrow).
Another area, high power. Corp rond at arrow.
Another area, high power. Corp rond at arrow.

Click on your browsers 'Back' button to go to previous page.