Unit:
Τομέας ΚλινικοεργαστηριακόςLibrary of the School of Health Sciences
Dissertation committee:
Αρώνη Κυριακή Καθηγήτρια, Πατσούρης Ευστράτιος Καθηγητής, Αγαπητός Εμμανουήλ Καθηγητής
Original Title:
Ανοσοϊστοχημική διερεύνηση της παροδικής ακανθολυτικής δερματοπάθειας. Συσχέτιση κλινικής και ιστολογικής εικόνας
Translated title:
Immunohistochemical findings in Grover's disease and clinicopathologic correlation
Summary:
Grover’s disease is an acquired papulovesicular eruption of unknown etiology,
first characterized by Ralph W. Grover in 1970 that shows shows a wide range of
morphology both clinically and histologically.
A total of 110 skin samples fulfilling the clinical and histopathological
criteria of Grover’s disease were evaluated. The microscopic slides came from
the records of the department of dermatopathology of the Medical School of the
University of Athens, between 1992 and 2013. Biopsy size was appoximately 4mm
(between 3 to 5mm) in diameter and in most cases corresponded to punch biopsy
specimens.
Of the 110 patients studied, 56 were male and 54 were female with a
male to female ratio almost 1:1 and a mean age of 57.2 years (range: 14-100).
The age did not seem to vary between men and women.The different expression of
the disease prompted us besides the study of the histology of the disease, to
the formation of two basic histology groups: the group in which the basic
pattern is dermatitis and the group in which the basic pattern is acantholytic
with minimal spongiosis.
The most frequent pattern in our study was that of the spongiotic dermatitis.
From the mostly acantholytic second group the pattern that appeared more
frequently was that of pemphigus foliaceus.
The presence of eosinophils within the dermis is a known histologic finding. We
observed a higher incidence rate than reported up to now (93.7%). We noted an
incidence rate of eosinophils within the epidermis (58.2%), but an even higher
rate of eosinophils on the nerve fibres (74.5%) which we consider to be a very
helpful diagnostic indicator for Grover’s disease.
Mast cells were detected in various numbers in almost all cases of
Grover’s disease whereas most of the times showed a moderate or intense
infiltrate. The increased numbers of mast cells could probably explain the
fibroblastic reaction that was observed in almost half of the specimens.
Another interesting finding is the presence of basophils and Langerhans
cells in Grover’s disease. Langerhans cells seem to be related to the intensity
of the inflammation and with that observation their numbers were mostly
increased in the first group in comparison with the other two groups. Another
interesting correlation is that the higher the number of Langerhans cells
within the epidermis, the higher the number of mast cells within the dermis. It
seems that a combination of mechanisms that act complementary to one another
are needed for the reaction of the organism.
Keywords:
Grover's disease, Immunohistochemistry, Histopathologic findings, Langerhans cells, Eosinophils
Number of references:
384
