Grover's disease: dermoscopy, reflectance confocal microscopy and histopathological correlation

Area of Science:

• Dermatology
• Medical Imaging
• Histopathology

Background:

• Grover's disease is a benign skin condition with unknown etiology.
• It presents with a papulovesicular eruption and characteristic intraepidermal clefting.
• Histopathology reveals four patterns: Darier-like, pemphigus-like, spongiotic, and Hailey-Hailey-like.

Purpose of the Study:

• To describe a case of Grover's disease with a Darier-like histopathological pattern.
• To evaluate the utility of polarized light dermoscopy (PLD) and handheld reflectance confocal microscopy (RCM) in diagnosing this condition.
• To explore non-invasive diagnostic methods for Darier-like Grover's disease.

Main Methods:

• Case report of a 54-year-old female with Grover's disease.
• Application of polarized light dermoscopy (PLD) for in-vivo imaging.
• Utilization of handheld reflectance confocal microscopy (RCM) for detailed cellular and tissue analysis.
• Correlation of imaging findings with clinical presentation and histopathology.

Main Results:

• PLD identified polygonal, star-like yellowish/brownish areas with a whitish halo.
• RCM revealed intraepidermal dark spaces (clefts), bright acantholytic keratinocytes, target-like dyskeratotic cells, and hyperparakeratosis.
• These findings corresponded to the Darier-like histopathological pattern of Grover's disease.

Conclusions:

• Polarized light dermoscopy (PLD) and handheld reflectance confocal microscopy (RCM) show promise for the non-invasive diagnosis of Grover's disease.
• Combined with clinical data, these imaging techniques can aid in identifying the Darier-like histopathological pattern.
• Further research may establish PLD and RCM as standard diagnostic tools for specific Grover's disease subtypes.