A Rare Case of Transient Acantholytic Dermatosis (AKA. Grover’s Disease) with Concomitant Pediculosis Pubis: An Atypical Presentation and First Documented Case Report

A 66-year-old male presented with a one-month history of persistent pruritic eruptions distributed mainly on the trunk. A punch biopsy from the left upper abdomen revealed focal acantholytic dyskeratosis with mixed inflammatory infiltrate in the dermis composed of numerous eosinophils. Grover’s disease was diagnosed based on the clinical and histopathological findings. Appropriate treatment was initiated but failed to relieve symptoms of itchiness. A further investigation of the hair follicles under mineral oil preparation revealed an infestation of pediculosis pubis. Subsequent treatment with Ivermectin and permethrin cream led to the complete resolution of his symptoms. This case report highlights an unusual and first documented case of Grover’s disease with a concomitant infestation of pediculosis pubis. To date, no reported cases in the literature have associated Grover’s disease with pubic lice infestation. However, there are three reported cases of concurrent scabies and Grover’s disease in the literature. This rare case underscores the clinical value in further investigating treatable underlying conditions in patients with suspected transient acantholytic dermatosis.

Human infestation with pubic lice

Pediculosis pubis is caused by Phthirus pubis (diptera: anoplura) commonly known as crab louse, an obligatory ectoparasite, found on human hair and requires human blood to survive. Pubic lice can be found on pubic hair, underarms, thigh and leg hair, beard and rarely on eyebrows and eyelashes. They are rarely found on scalp hair. Spread of lice occurs mostly by sexual contact but spread via non-sexual contact although rare has also been reported. I present the case of a middle-aged woman with pubic lice. No lice/nits were found in underarm hair, eyebrows or eyelashes. A review of literature is enclosed.