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Acantholysis

Differential Diagnosis:

Differential Diagnosis:

Pathophysiology:

■ Genodermatosis of autosomal dominant inheritance produced by abnormalities in desmosomal adhesion between keratinocytes. ATP2A2 has been identified as the causative gene for keratosis follicularis.

References:

1. Kosann MK. Keratosis follicularis. Dermatol Online J 2003; 9:35.

2. Dhitavat J, Fairclough RJ, Hovnanian A, Burge SM. Calcium pumps and keratinocytes: lessons from Darir's disease and Hailey-Hailey disease. Br J Dermatol 2004; 150:821-828.

3. Sehgal VN, Srivasrava G. Darier's (Darier-White) disease/kera-tosis follicularis. Int J Dermatol 2005; 44:184-192.

TRANSIENT ACANTHOLYTIC DERMATOSIS (FIG. 11)

Synonym: Grover's disease. Clinical Presentation:

■ Pruritic, papular, and vesicular eruption typically occurring on the trunk

■ More common in middle-aged and elderly individuals, particularly males

■ Predominantly self-limited but may pursue a chronic course

Histology:

■ Focal changes

■ Mild epidermal hyperplasia

■ Four patterns within the epidermis that may occur independently or intermixed:

■ Pemphigus pattern with suprabasilar acantholysis

■ Familial pemphigus pattern with partial acantholysis

■ Keratosis follicularis pattern with corps ronds and corps grains

■ Spongiotic pattern

Differential Diagnosis:

See "Differential Diagnosis" table under section "Keratosis Follicularis."

Pathophysiology:

The etiology is unknown, but excessive ultraviolet light exposure, heat, sweating, and ionizing radiation have been linked to the disease.

Reference:

1. Davis MD, Dinneen AM, Landa N, Gibson LE. Grover's disease: clinicopathologic review of 72 cases. Mayo Clin Proc 1999; 74:229-234.

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