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Atypical Variant of Galli–Galli Disease (Grover-Like Eruption With Lentiginous Freckling) in a Liver Transplant Patient

Rongioletti, Franco MD*†; Fausti, Valentina MD*; Christana, Konstantina MD*; Montinari, Martina MD*; Parodi, Aurora MD*; Fiocca, Roberto MD

The American Journal of Dermatopathology: July 2011 - Volume 33 - Issue 5 - p 504-507
doi: 10.1097/DAD.0b013e3181ea139b
Extraordinary Case Report

Galli-Galli disease is considered as a rare variant of Dowling-Degos disease, sharing the same clinical features of reticulate hyperpigmentation of the flexures. Histopathologically, there is acantholysis and suparabasal lacunae. Grover disease (transient acantholytic dermatosis) is a transient dermatosis which clinically presents as an eruption of erythematous excoriated papules located on the trunk and histologically with dyskeratosis and acantholysis. Grover disease has occasionally been reported in patients with chronic renal failure, human immunodeficiency virus infection, hematological malignancies, bone marrow allotransplantation, and renal transplantation. We report herein a case of atypical variant of Galli-Galli disease occurring in a liver transplant patient in whom the leading sign of reticulate hyperpigmentation of the large flexures was lacking. Instead, Grover-like, erythematous, keratotic, excoriated papules and lentigo-like macules with predilection for the trunk were found. Histopathology of both, an excoriated papule and a lentigo-like macule revealed the diagnostic features of Galli-Galli disease namely, elongated, pigmented, finger-like rete ridges, intraepidermal lacunae and acantholysis. However, serial sections of the lentigo-like macule were needed to reveal some suprabasal and subcorneal lacunae with minimal acantholysis. Thus, a good clinicopathological correlation is essential to make the right diagnosis of Galli-Galli disease. Although Grover disease has been described in the setting of solid organ transplantation and immunosuppression, this is the first report of an atypical variant of Galli-Galli disease occurring in a liver transplant patient.

From the *Section of Dermatology, Department of Endocrinological and Medical Sciences; and †Institute of Pathology, University of Genoa, Genoa, Italy.

Conflict of interest: None.

Reprints: Franco Rongioletti, MD, Clinica Dermatologica, Università di Genova, viale Benedetto XV 7, 16132 Genova, Italy (e-mail:

© 2011 by Lippincott Williams & Wilkins.