Metformin, sold under the brand name Glucophage, among others, is the main first-line medication for the treatment of type 2 diabetes, particularly in people who are overweight. It is also used in the treatment of polycystic ovary syndrome. It is not associated with weight gain and is taken by mouth. It is sometimes used as an off-label adjunct to lessen the risk of metabolic syndrome in people who take antipsychotics.Metformin is generally well tolerated. Common adverse effects include diarrhea, nausea, and abdominal pain. It has a small risk of causing low blood sugar. High blood lactic acid level is a concern if the medication is used in overly large doses or prescribed in people with severe kidney problems. It is not recommended in those with significant liver disease. Metformin is a biguanide antihyperglycemic agent. It works by decreasing glucose production in the liver, by increasing the insulin sensitivity of body tissues, and by increasing GDF15 secretion, which reduces appetite and caloric intake.Metformin was discovered in 1922. French physician Jean Sterne began the study in humans in the 1950s. It was introduced as a medication in France in 1957 and the United States in 1995. It is on the World Health Organizations List of Essential Medicines. Metformin is the most widely used medication for diabetes taken by mouth. It is available as a generic medication. In 2020, it was the third most-commonly prescribed medication in the United States, with more than 92 million prescriptions.
Grovers disease (GD) is a polymorphic, pruritic, papulovesicular dermatosis characterized histologically by acantholysis: 529  with or without dyskeratosis. Once confirmed, most cases of Grovers disease last six to twelve months, which is why it was originally called "transient". However it may last much longer. Nevertheless, it is not to be confused with relapsing linear acantholytic dermatosis. Signs and symptoms
Grovers disease often starts quite suddenly. There are intensely itchy spots on the central back, mid chest and occasionally elsewhere. Frequently, it follows sweating or some unexpected heat stress. The itchy eruption lasts an average of 10–12 months. It is characterized by papules and papulovesicles with excoriations occurring on the chest, back, lower sternum, arms, and thighs. The papules are most commonly found on the mid chest. Sometimes the features of Grovers are found in people who do not itch or have a conspicuous rash. Most of the people with Grovers who visit a dermatologist, however, itch a lot. Cause
The cause of Grovers disease is unknown. Suspected triggers of disease activity include heat and sweating, sunlight, and adverse reaction to medications: 24  as well as ionizing radiation, end-stage renal disease/hemodialysis, and mechanical irritation or prolonged bed rest. Some cases of Grovers disease have been associated with medications such as sulfadoxine-pyrimethamine, ribavirin, cetuximab, and interleukin-4 [1,8-15]. One series of 300 patients with Grovers disease reported an association with other coexisting dermatoses including atopic dermatitis, contact dermatitis, and xerosis cutis. Finally, smaller series have detailed an association with pyoderma gangrenosum, bacterial and viral infections, and occasionally, malignancies.