DEAR DR. ROACH: My husband has a terrible rash on his back and front, diagnosed by a dermatologist as Grover’s disease. He is 79 and has had it for five years. My husband’s internist said it would go away within six to 12 months, but his never went away. The doctor gave him some triamcinolone cream, and it helped, but the rash is still bothersome. Do you know if there’s anything better, or will he have to live with this? — L.S.

ANSWER: Grover’s disease was described in 1970, and the original report showed that the rash cleared up within weeks; however, the same rash and biopsy findings have subsequently been described in people with chronic disease. Grover’s disease is most often found in lighter-skinned people over 40, and it affects men more than women. The cause is unknown, but there are many triggers, including cold air, heat and sweating, sunlight and medications.

Your husband has the typical distribution of the rash, on the chest and back. It often is extremely itchy.

Unfortunately, there isn’t a cure for Grover’s disease, and I can’t tell you if your husband’s case is going to finally go away by itself. Treatment is to avoid triggers, if known and possible to do. When that isn’t possible, over-the-counter moisturizing creams help some people, but most require steroid creams like the triamcinolone your husband uses. Some people need even higher-potency topical creams.

If these aren’t adequate, topical vitamin D creams have been used, and some people need oral antihistamines. The most recalcitrant cases may require systemic treatment with oral steroids, vitamin A analogs like isotretoin, or ultraviolet light treatment. These need to be supervised by an expert in Grover’s disease, as UV light can make the disease worse, initially.

DEAR DR. ROACH: I have a condition that I believe is unusual. I am female, nearly 80 years young and am in excellent physical and usually excellent mental health.

Every spring, I have an “emotional crisis.” It comes on suddenly. I feel very depressed, become emotional and want to stay isolated (normally I am extroverted). I prefer cold weather. I will be this way six to eight weeks — sometimes longer. I can’t follow through on my responsibilities, and I can’t explain what’s wrong (and I don’t want to anyway). When I start to feel better, I can feel “it” start to leave my body.

Do I see a medical doctor or a psychiatrist? — B.J.

ANSWER: This sounds to me like a mental illness, though I should point out that the distinction between medical disease and physical ones isn’t particularly useful. The brain or mind can become disordered just like any other organ system.

The fact that this happens in springtime makes me wonder about seasonal affective disorder. While the majority of people with SAD have depressive symptoms in the winter, there is a small subset who have symptoms in spring or summer. Light therapy, useful for some people with SAD in winter, is of no value in the spring-onset SAD.

Like other types of depressive episodes, SAD may be treated with medication, psychotherapy or both. Fluoxetine in particular has been studied for SAD, as has cognitive-behavioral therapy. A psychiatrist can help decide what is the best treatment in your case.

Finally, some people with depression tend to worsen around anniversaries or other reminders of a life-changing event, which might be another explanation for the fact that these symptoms recur every spring.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.

Copy the Story Link