Aljarbou Ohoud Z, Asgari Masoud, Al-Saidi Nagla, Silloca-Cabana Elizabeth O, Alathamneh Mamoun, P Sangueza Omar
Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Department of Pathology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston Salem, NC.
Am J Dermatopathol. 2018 Sep;40(9):642-646. doi: 10.1097/DAD.0000000000001112.
Grover disease is an entity whose diagnosis is based on clinicopathologic correlation. Histopathologically, focal acantholysis is the most common finding. In some cases, there is prominent squamous atypia which can prove to be very challenging and the lesion may be confused with an epidermal neoplasm.
To report on atypical histopathological changes in Grover disease and to provide helpful clues to differentiate between the epidermal atypia seen in some cases of Grover disease and epithelial neoplasms.
We analyzed 33 cases of Grover disease histologically diagnosed at Wake Forest Baptist Medical Center, NC, between 2011 and 2017. Atypical changes in keratinocytes were defined as epithelial buds, nuclear pleomorphism, and dyskeratosis in all layers of epidermis or altered granular layer.
Twenty cases (64%) showed foci with alteration of the normal keratinocytic maturation, whereas 18 cases demonstrated nuclear pleomorphism. Buds of epithelial cells emanating from the basal layer of the epidermis and granular cell alteration was present in 19 cases.
The findings especially the presence of an altered granular layer may represent a diagnostic clue in cases of Grover disease with atypical changes.
格罗弗病是一种基于临床病理相关性进行诊断的疾病。在组织病理学上，局灶性棘层松解是最常见的表现。在某些病例中，存在显著的鳞状上皮异型性，这可能极具挑战性，且病变可能与表皮肿瘤相混淆。
报告格罗弗病非典型组织病理学变化，并为鉴别格罗弗病某些病例中所见的表皮异型性与上皮肿瘤提供有用线索。
我们分析了2011年至2017年期间在北卡罗来纳州韦克福里斯特浸礼会医疗中心经组织学诊断为格罗弗病的33例病例。角质形成细胞的非典型变化定义为上皮芽、核多形性以及表皮各层或颗粒层改变中的角化异常。
20例（64%）显示正常角质形成细胞成熟发生改变的病灶，而18例表现出核多形性。19例存在从表皮基底层发出的上皮细胞芽以及颗粒细胞改变。
这些发现，尤其是颗粒层改变的存在，可能是格罗弗病非典型变化病例中的诊断线索。
