Case 1: In this example, acanthoylsis and dyskeratosis are not prominent features. There is some hyperkeratosis and epithelial hyperplasia, probably as a consequence of rubbing.

A perivascular lymphocytic infiltrate is common.

Note the spongiosis, parakeratosis and suggestion of dyskeratosis (corps ronds and corps grains) at the lower left.

Periadnexal inflammatory was present as well.

Grover disease, also known as transient acantholytic dermatosis, has a strong predilection for males. These discrete red papules usually involve the trunk, resembling a heat rash. Pruritis is usually out of proportion to its fairly benign appearance. Exacerbating factors include heat or strenuous exercise.

Histologically, acantholysis is seen but may be very subtle. Hyperkeratosis, parakeratois, dyskeratosis, and spongiosis are also common features. An inflammatory infiltrate (lymphocytes and eosinophils) is usually distributed in a perivascular pattern in the dermis (Rapini, Busam).

Commonly affects middle-aged to elderly males (M:F ratio of 3:1). Very itchy papules appear on the trunk that resemble a heat rash (Zabawski).

Usually self-limited but in some cases, the rash can be chronic and difficult to treat. Topical steroid, avoidance of exacerbating factors and retinoids are treatment options.

• Epidermis : Darier Disease