fbpx
Ralph Weir Grover (1920-2008) 600

Ralph Weir Grover (1920-2008) was an American Dermatologist

A respected teacher, researcher, diagnostician and histopathologist by colleagues and students, he spent the majority of his working career as a solo practitioner working from a home office in Floral Park, NY. He spent years refining his expert skills in cytology and was noted to have been able to do a ‘virtual Moh’s’ procedure before the technique was used on a large scale. These skills ultimately led him to discover Transient Acantholytic Dermatosis, or Grover Disease in 1970.

A man of intense intellectual prowess, he was known and admired for his many hobbies and areas of academic interest, namely languages, history, music, and land and ocean fauna. 


Biography
  • Born on December 26, 1920, in Jersey City, New Jersey
  • 1942 – Undergraduate degree from Harvard University. Member of the German club and Glee club.
  • 1944 – MD, Columbia College of Physicians and Surgeons
  • Spent two years practicing at a Veterans hospital in Arkansas, where his interest in Dermatology was crystallised 
  • Dermatology Training in New York City at Skin and Cancer Hospital and Presbyterian Hospital 
  • Started the first Dermatology Clinic at Nassau County Medical Centre (formerly Meadowbrook Hospital)
  • Affiliated with St Frances Hospital in Roslyn and Eastern Long Island Hospital 
  • Captain in the Army Medical Crops immediately following World War II
  • Worked mostly as a solo practitioner in private practice in Floral Park, NY for 37 years until his retirement.
  • Member of the clinical faculty of the Department of Dermatology at SUNY Stony Brook
  • Honorary member of the Pan American Medical Association
  • Retired 1988
  • Died on May 25, 2008 in Shelburne, Chittenden, Vermont

Medical Eponyms
Grover disease (1970)

In 1970, Grover presented a series of six patients with a unique primary acantholytic skin disease. They demonstrated pruritic, papular and/or papulovesicular truncal eruptions that resolved within weeks. Histopathologic findings were consistent with Hailey-Hailey or Darier’s disease, demonstrating epidermal acantholysis. The presentations were, however, clearly separable from these eruptions on clinical grounds. 

Grover was known by his colleagues at the time to have near perfected techniques of cytology, often performing Tzanck smears on many clinical specimens. It was through these techniques he was able to discover Grover’s disease. 

These patients did not appear to have any of the three generally recognized primary acantholytic diseases. The histologic suggestions of Hailey-Hailey’s disease or Darier’s disease, in particular, are not supported by the clinical features. None of the patients had the clinical hallmarks of familial benign chronic pemphigus, such as a tendency for the individual lesions to involve intertriginous areas and to spread centrifugally, or a tendency to chronic recurrence. In Darier’s disease an onset so late in life would be most unusual, since it starts before the 40th year in 93% of cases, and less than 2% begin after the 60th year. Further, keratosis follicularis is a chronic and relentlessly progressive affliction in which a rapid onset, followed by healing within a few weeks or months, would be exceptional. The benign course of the disease is not compatible with common pemphigus and its variants.

The term “transient acantholytic dermatosis” seems a useful descriptive term for this group of patients. It indicates the basic pathologic change and, at the same time, indicates the principal point of clinical differentiation from the other forms of primary acantholytic disease — the characteristic of transiency.

Grover, 1970
Original images
Grover disease 1970 A B
A. Edematous papular eruption of the back in case 6.
B. The limited, edematous, papulovesicular eruption of the chest in case 4.
Transient acantholytic dermatosis. Grover 1970
Grover disease 1970 C D
C. Anterior aspect of the trunk in case 3. Widespread, discrete, vesiculopapules with a mild surrounding inflammatory reaction can be seen.
D. Close-up of the xiphoid area in case 2. The edematous papulovesicular lesions occur singly or tend to form herpetiform, confluent groups with occasional traces of superficial desquamation.
Transient acantholytic dermatosis. Grover 1970

Today, the disease is also commonly eponymously referred to as Grover’s disease. It is a transient primary acantholytic dermatosis, as its original name implies. It often affects Caucasian men over the age of 50 with sun-damaged skin, though its epidemiological profile is not well understood. Its cause remains unknown. The disease presents generally as Grover originally described it, with intensely pruritic small erythematous papular or papulovesicular lesions on the back, chest and upper arms. Histopathological findings are of acantholysis with or without dyskeratosis. It is often treated symptomatically and self-resolves within 2-4 weeks, though it has demonstrated relapsing or chronic course variants. 


Major Publications

Other Interests
  • Well known to have kept pet ducks at his home
  • Spoke seven languages including English, Italian, Swahili, German and Russian
  • Studied Beethoven’s piano sonatas, ocean fauna, birds
  • Previously a radio operator 

References

Biography

Eponymous terms


[cite]


BSc, MD from University of Western Australia. Junior Doctor currently working at Sir Charles Gairdner Hospital.

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.