Doc: Typical rash of grover’s disease is on chest, back

Dear Dr. Roach: My husband has a terrible rash on his back and front, diagnosed by a dermatologist as Grover’s disease. He is 79 and has had it for five years. My husband’s internist said it would go away within six to 12 months, but his never went away. The doctor gave him some triamcinolone cream, and it helped, but the rash is still bothersome. Do you know if there’s anything better, or will he have to live with this?

L.S.

Dear L.S.: Grover’s disease was described in 1970, and the original report showed the rash cleared up within weeks; however, the same rash and biopsy findings have subsequently been described in people with chronic disease. Grover’s disease is most often found in lighter-skinned people over 40, and it affects men more than women. The cause is unknown, but there are many triggers, including cold air, heat and sweating, sunlight and medications.

Your husband has the typical distribution of the rash, on the chest and back. It often is extremely itchy.

Unfortunately, there isn’t a cure for Grover’s disease, and I can’t tell you if your husband’s case is going to finally go away by itself. Treatment is to avoid triggers, if known and possible to do. When that isn’t possible, over-the-counter moisturizing creams help some people, but most require steroid creams like the triamcinolone your husband uses. Some people need even higher-potency topical creams.

If these aren’t adequate, topical vitamin D creams have been used, and some people need oral antihistamines. The most recalcitrant cases may require systemic treatment with oral steroids, vitamin A analogs like isotretoin, or ultraviolet light treatment. These need to be supervised by an expert in Grover’s disease, as UV light can make the disease worse, initially.

Dear Dr. Roach: I heard that letting vinegar touch your skin causes arthritis. Is there any danger in using vinegar as a cleaning agent?

N.J.A.

Dear N.J.A.: I often get asked whether apple cider vinegar cures arthritis (it doesn’t) or can help relieve symptoms (it might, but there is no good evidence that it does). Vinegar is a mild acid that normally isn’t irritating to the skin.

Email questions to ToYourGoodHealth@med.cornell.edu.