Successful treatment of Grover’s disease with upadacitinib: A case report

Transient acantholytic dermatosis, also known as Grover’s disease, is an acquired pruritic eruption commonly refractory to conventional therapies. We report a case of a 76-year-old male with Grover’s disease presenting with persistent pruritus and skin lesions despite multiple treatments. Upadacitinib 15 mg once daily was initiated off-label and the patient reported marked improvement in pruritus within 2 days of treatment and substantial reduction in lesion burden after 1 month. The etiology of Grover’s disease is unclear but is believed to be due in part to occlusion and damage to the sweat glands. Emerging responses to immunomodulatory therapies suggest immune dysregulation may contribute to select cases of Grover’s disease. Upadacitinib, a selective Janus kinase 1 inhibitor, reduces pruritus and inflammation-associated cytokine signaling and represents a plausible therapeutic strategy. To our knowledge, this is the first reported case of Grover’s disease successfully treated with Janus kinase inhibition.