Derm SAQs ·
Grover's disease (transient acantholytic dermatosis) - SAQ
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Stem
A 62-year-old man is admitted to the orthopaedic ward following fixation of a fractured neck of femur. On day 6 post-op he develops an intensely itchy eruption of 1-3 mm erythematous, firm papules and papulovesicles on his central chest and upper back. The rest of the skin examination is normal; there is no mucosal, facial, palmar or plantar involvement. He is febrile at 37.9 degrees C and is on regular paracetamol, oxycodone, enoxaparin and a recent course of flucloxacillin for a wound infection.
Questions
a) What is the most likely diagnosis and what clinical features support it? (2 marks)
b) What investigation would you arrange to confirm the diagnosis, and what would you expect to find? (3 marks)
c) Outline your stepwise management plan for this patient. (3 marks)
d) What are the key complications and prognostic factors? (2 marks)