Grover's disease in a peritoneal dialysis patient
Enfermedad de Grover en un paciente en diálisis peritoneal
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Chronic kidney disease under dialysis is a predisposing condition due to mechanisms that have not been fully explained. We report the case of a 68-year-old male with polycystic kidney disease who had been on continuous ambulatory peritoneal dialysis for six months, with benign prostatic hyperplasia that caused multiple recurrent urinary tract infections. He received prophylactic treatment with trimethoprim/sulphamethoxazole (TMP-SMX). He sought consultation due to 38°C fever, general discomfort, asthenia and, 48 hours previously, he had developed erythematous pruritic maculopapular lesions on his trunk and subsequently on his limbs. On physical examination, the patient was afebrile, with erythematous maculopapular rash on his trunk and limbs (Figure 1). There were no relevant findings in the remaining physical examination. Complementary examinations showed bicytopenia with no other findings. A skin biopsy was performed (Figure 2), revealing suprabasal acantholysis with the presence of dyskeratotic cells in the superficial layers in the form of grains and round bodies and mild dermal perivascular inflammatory infiltrate in the superficial dermis; these findings are consistent with Grover's disease. Icodextrin was replaced with dextrose-based solutions, sulphonamide was discontinued and there was remission of skin lesions and bicytopenia. With TMP-SMX initially being considered as a potential ethological agent, the dialysis solution with icodextrin was reintroduced and the skin exanthema returned in a week. Improvement was observed with the introduction of topical corticosteroids and the discontinuation of icodextrin.</p><p class="elsevierStylePara">Transient and persistent acantholytic dermatosis (TAD) was initially described by Ralph Grover as a transient papulovesicular rash that compromised the trunk and thighs.<span class="elsevierStyleSup">1</span> It is usually self-limiting<span class="elsevierStyleSup">2</span> and primarily affects Caucasian adults from the fifth decade of life with a 1.6 to 2.1 male/female ratio.<span class="elsevierStyleSup">3</span> Its aetiology is unknown and has been associated with overexposure to the sun, feeling hot, fever, sweating, states of immunodeficiency, neoplasias and other dermatoses.<span class="elsevierStyleSup">1</span> Some cases have been associated with drugs, among them, sulphadoxine/pyrimethamine.<span class="elsevierStyleSup">4</span> Chronic kidney disease receiving treatment with dialysis is a recently identified associated condition. Until present, TAD has been reported in seven haemodialysis patients and only in two patients on peritoneal dialysis.<span class="elsevierStyleSup">2</span> In these cases, the lesions were persistent, apart from in four patients, in whom renal transplantation was performed. In most cases Grover's disease mainly affects the trunk. The rash is papular, erythematous and intensely pruritic. Histopathologically, the common denominator is acantholysis, defined as the dissociation of keratinocytes from the epidermis.<span class="elsevierStyleSup">4</span> The differential diagnosis is made with genodermatosis, pemphigus and Galli-Galli disease. Topical corticosteroids, antihistamines, moisturisers and emollients are the first line therapeutic agents. In persistent or recurrent cases, the following is recommended: systemic corticosteroids, topical vitamin D analogues, systemic retinoids, phototherapy and PUVA (psoralen plus ultraviolet A photochemotherapy).</p><p class="elsevierStylePara">This case was initially targeted as TAD secondary to sulpha drugs. However, our attention is drawn to the exacerbation and subsequent remission of symptoms with the reintroduction and then discontinuation of icodextrin-based dialysis solutions. The use of icodextrin in peritoneal dialysate has been associated with the onset of erythroderma, atopic dermatitis and other generalised rash exanthemas.<span class="elsevierStyleSup">5</span> TAD should be considered in the differential diagnosis of skin diseases in chronic kidney disease patients who receive renal replacement therapy.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara">The authors declare that they have no conflicts of interest related to the contents of this article.</p><p class="elsevierStylePara"><a href="grande/11220_16025_49194_en_f111220.jpg" class="elsevierStyleCrossRefs"><img src="11220_16025_49194_en_f111220.jpg" alt="Erythematous maculopapular rash on the trunk"></img></a></p><p class="elsevierStylePara">Figure 1. Erythematous maculopapular rash on the trunk</p><p class="elsevierStylePara"><a href="grande/11220_16025_49196_en_f211220.jpg" class="elsevierStyleCrossRefs"><img src="11220_16025_49196_en_f211220.jpg" alt="Skin biopsy consistent with Glover’s disease"></img></a></p><p class="elsevierStylePara">Figure 2. Skin biopsy consistent with Glover’s disease</p>" "pdfFichero" => "P1-E557-S4311-A11220-EN.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "11220_16025_49194_en_f111220.jpg" "Alto" => 486 "Ancho" => 654 "Tamanyo" => 74490 ] ] "descripcion" => array:1 [ "en" => "Erythematous maculopapular rash on the trunk" ] ] 1 => array:8 [ "identificador" => "fig2" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "11220_16025_49196_en_f211220.jpg" "Alto" => 488 "Ancho" => 656 "Tamanyo" => 177982 ] ] "descripcion" => array:1 [ "en" => "Skin biopsy consistent with Glover’s disease" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Parsons JM. Transient acantholytic dermatosis (Grover¿s disease): a global perspective. J Am Acad Dermatol 1996;35:653-66." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "González-Sixto B, Rosón E, De la Torre C, García-Doval I, Cruces M. Grover¿s disease in a patient undergoing peritoneal dialysis woth resolution after renal transplant. Acta Derm Venereol 2007;87(6):561-2. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17989906" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:1 [ "itemHostRev" => array:3 [ "pii" => "S0735109708026090" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Heenan PJ, Quirk CJ. Transient acantholytic dermatosis. Br J Dermatol 1980;102(5):515-20. <a href="http://www.ncbi.nlm.nih.gov/pubmed/7387898" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:1 [ "itemHostRev" => array:3 [ "pii" => "S0735109706024636" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Hashimoto K, Moiin A, Chang MW, Tada J. Sudoriferous acrosyringeal acantholitic disease. A subset of Grover´s disease. J Cutan Pathol 1996;23(2):151-64. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8721450" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:1 [ "itemHostRev" => array:3 [ "pii" => "S0735109705019996" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Frampton JE, Plosker GL. Icodextrin: a review of its use in peritoneal dialysis. Drugs 2003;63(19):2079-105. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12962523" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003300000004/v0_201502091629/X2013251413052713/v0_201502091630/en/main.assets" "Apartado" => array:4 [ "identificador" => "35437" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor - Brief Case Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003300000004/v0_201502091629/X2013251413052713/v0_201502091630/en/P1-E557-S4311-A11220-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413052713?idApp=UINPBA000064" ]
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| 2021 October | 62 | 42 | 104 |
| 2021 September | 42 | 33 | 75 |
| 2021 August | 45 | 41 | 86 |
| 2021 July | 52 | 38 | 90 |
| 2021 June | 57 | 19 | 76 |
| 2021 May | 85 | 29 | 114 |
| 2021 April | 194 | 17 | 211 |
| 2021 March | 104 | 25 | 129 |
| 2021 February | 113 | 17 | 130 |
| 2021 January | 54 | 12 | 66 |
| 2020 December | 56 | 18 | 74 |
| 2020 November | 49 | 18 | 67 |
| 2020 October | 48 | 8 | 56 |
| 2020 September | 51 | 6 | 57 |
| 2020 August | 38 | 8 | 46 |
| 2020 July | 31 | 5 | 36 |
| 2020 June | 60 | 10 | 70 |
| 2020 May | 60 | 13 | 73 |
| 2020 April | 48 | 9 | 57 |
| 2020 March | 36 | 11 | 47 |
| 2020 February | 35 | 18 | 53 |
| 2020 January | 50 | 20 | 70 |
| 2019 December | 36 | 17 | 53 |
| 2019 November | 33 | 17 | 50 |
| 2019 October | 30 | 8 | 38 |
| 2019 September | 30 | 16 | 46 |
| 2019 August | 27 | 11 | 38 |
| 2019 July | 26 | 20 | 46 |
| 2019 June | 27 | 11 | 38 |
| 2019 May | 27 | 13 | 40 |
| 2019 April | 94 | 35 | 129 |
| 2019 March | 53 | 22 | 75 |
| 2019 February | 32 | 15 | 47 |
| 2019 January | 57 | 25 | 82 |
| 2018 December | 82 | 37 | 119 |
| 2018 November | 109 | 7 | 116 |
| 2018 October | 106 | 13 | 119 |
| 2018 September | 88 | 8 | 96 |
| 2018 August | 56 | 16 | 72 |
| 2018 July | 64 | 14 | 78 |
| 2018 June | 53 | 10 | 63 |
| 2018 May | 54 | 12 | 66 |
| 2018 April | 82 | 9 | 91 |
| 2018 March | 68 | 8 | 76 |
| 2018 February | 84 | 9 | 93 |
| 2018 January | 63 | 8 | 71 |
| 2017 December | 77 | 13 | 90 |
| 2017 November | 50 | 5 | 55 |
| 2017 October | 47 | 4 | 51 |
| 2017 September | 44 | 7 | 51 |
| 2017 August | 48 | 13 | 61 |
| 2017 July | 39 | 10 | 49 |
| 2017 June | 39 | 8 | 47 |
| 2017 May | 48 | 17 | 65 |
| 2017 April | 39 | 6 | 45 |
| 2017 March | 31 | 11 | 42 |
| 2017 February | 74 | 5 | 79 |
| 2017 January | 40 | 7 | 47 |
| 2016 December | 47 | 8 | 55 |
| 2016 November | 78 | 7 | 85 |
| 2016 October | 121 | 13 | 134 |
| 2016 September | 140 | 4 | 144 |
| 2016 August | 183 | 5 | 188 |
| 2016 July | 185 | 8 | 193 |
| 2016 June | 125 | 0 | 125 |
| 2016 May | 110 | 0 | 110 |
| 2016 April | 91 | 0 | 91 |
| 2016 March | 87 | 0 | 87 |
| 2016 February | 96 | 0 | 96 |
| 2016 January | 92 | 0 | 92 |
| 2015 December | 121 | 0 | 121 |
| 2015 November | 73 | 0 | 73 |
| 2015 October | 72 | 0 | 72 |
| 2015 September | 86 | 0 | 86 |
| 2015 August | 80 | 0 | 80 |
| 2015 July | 56 | 0 | 56 |
| 2015 June | 35 | 0 | 35 |
| 2015 May | 48 | 0 | 48 |
| 2015 April | 6 | 0 | 6 |
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