Grover's or Something Else?
This is a 68-year-old man who
arrived in our clinic complaining of a rash on his trunk beginning four weeks
prior. Treatment by his primary included anti-fungal creams and OTC
His first presentation
resembled Grover's and was later confirmed by punch biopsy. The puritis seemed to be under control with Clobetasol solution
mixed in Cerave cream. I also added Hydroxyzine 50mg QHS as needed for
We had his symptoms 90% improved
and the lesions were faded about 75% with no evidence of new lesions.
Exactly three weeks
from his first visit he returned complaining of a "new rash". Upon
examination were intact subepitheial bullous lesions on trunk and arms ranging
from 4mm to the largest measuring 8mm.
screamed bullous impetigo and was confirmed by two punch biospies.
Initially, we started
him on 40mg Prednisone QD but new bullae was forming, so we increased
his dosage to 80mg QD. We will complete two weeks on this dose and taper
him off. We also suggested he review blood pressure medications with his