Granulosis rubra nasi is a rare condition characterised by hyperhidrosis of the nose. Granulosis Rubra Nasi (GRN) is a rare disorder of the eccrine glands. It is clinically characterized by hyperhidrosis of the central part of the face. Granulosis rubra nasi is a rare familial disease of children, occurring on the nose, cheeks, and chin, characterized by diffuse redness, persistent excessive.

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Beau’s lines Yellow nail syndrome Leukonychia Azure lunula shape: Multiple hyperpigmented papules and some vesicles present over the right side of the nose.

Saunders Elsevier publications; Other differential diagnosis include acne vulgaris, lupus pernio, and graunlosis erythematosus.

Granulosis rubra nasi | Primary Care Dermatology Society | UK

In the English literature Maschkillesson and Neradow have recorded cases and the disease was not thought to be rare. After 15 days of follow-up, the patient has shown good response Figure 3. Granulosis rubra nasi usually resolves spontaneously around puberty ; however, it occasionally persists indefinitely Treatment with glycopyrronium bromide cream, a topical anti-cholinergic, can improve symptoms Botulinum toxin injections have also been reported as effective.

G Ital Dermatol Venereol. Dermis shows villous hair follicle with sebaceous gland hyperplasia with peri-infundibular infiltrate of lymphocytes and plasma cells with dilated capillaries and extravasation of hemosiderin. The clinical picture is characterized by hyperhidrosis of the central part of the face, most conspicuous on the tip of the nose.

Physical examination of the nose revealed erythema and multiple telangiectatic vesicles.

It is described as a focal form of hyperhidrosis which differs from the other forms, as it does not depend on the hypothalamic or emotional stimuli [ 3 ]. The initial presentation is excess sweating of the tip of the nose with small visible beads of sweat With time erythema, papules, vesicles and telangiectasia may develop over the nose, cheeks, upper lip and chin.

Granulosis rubra nasi in a mother and daughter. Koilonychia Nail clubbing behavior: Patient was counseled regarding the disease and poor response to treatment. The pathogenesis is unknown. It is clinically characterized by hyperhidrosis of the central part of the face, most conspicuous on the tip of the nose, followed by appearance of diffuse erythema over the nose, cheeks, chin, and upper lip.


Small erythematous macules, papules, vesicles, or pustules lesions can also be seen [ 28 ].

Granulosis rubra nasi

This is followed by appearance of diffuse erythema over the nose, cheeks, chin, and upper lip. After another three months of follow up, patient had not developed any new lesions and had not experienced any significant side effects of Tacrolimus.

We hope this case report will prompt other authors to use and document the response of tacrolimus in various stages of GRN. Excessive sweating may precede other changes by several years. Counseling the patients about the self-limiting nature of the condition is of paramount importance.

Granulosis rubra nasi – Wikipedia

On ansi up after three weeks, size of the vesicles had decreased and patient stated no increase in size of the vesicles, even on sun exposure. Presence of significant increase in sweating on the nose and central face appears to be responsible for the secondary changes like erythema and erythematous papules [ 9 ].

We here report a case of GRN having lesions persisting in adulthood. The common differential diagnoses include miliaria crystallina, hidrocystoma, rosacea, periorificial dermatitis, acne vulgaris and milia.

New lesions kept appearing. Histologically, dilation of dermal blood, and lymphatic vessels with perivascular lymphocytic infiltration and dilation of sweat ducts at times simulating a hidrocystoma are seen.

This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A biopsy of the skin lesion was done. Hidrocystoma is characterized by cystic papules of about 1—3 mm in diameter usually appearing in the periorbital area of middle-aged or elderly women. Abstract A 20 granulosks girl presented with multiple asymptomatic reddish vesicles on face for four years.


However, erythema over the central face was persisting.

Granulosis rubra nasi: a rare condition treated successfully with topical tacrolimus

Hyperhidrosis and botulinum toxic in dermatology. The diagnosis is usually clinical. GRN is an inflammatory condition involving eccrine sweat glands of nose, cheeks and chin. Paronychia Acute Chronic Chevron nail Congenital onychodysplasia of the index fingers Green nails Half and half nails Hangnail Hapalonychia Hook nail Ingrown nail Lichen planus of the nails Longitudinal erythronychia Malalignment of the nail plate Median nail dystrophy Mees’ lines Melanonychia Muehrcke’s lines Nail—patella syndrome Onychoatrophy Onycholysis Onychomadesis Onychomatricoma Onychomycosis Onychophosis Onychoptosis defluvium Onychorrhexis Onychoschizia Platonychia Pincer nails Plummer’s nail Psoriatic nails Pterygium inversum rubrz Pterygium unguis Purpura of the nail bed Racquet nail Red lunulae Shell nail syndrome Splinter hemorrhage Spotted lunulae Staining of the nail plate Stippled nails Subungual hematoma Terry’s nails Twenty-nail dystrophy.

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Support Center Support Center. Within 1 year, she developed multiple erythematous papules patient stated lesions did not express fluid or whitish material on excoriation over nose and cheeks. Rook’s textbook of dermatology.

Views Read Edit View history. This chapter is set out as follows: In acute lupus erythematosus, there is a malar rash with mouth ulcers but there is no hyperhidrosis. She had consulted various doctors and was advised many medications, including anti-acne, antibiotic, antifungal and topical steroids, with no benefit.

A 20 years-old girl presented with multiple discrete asymptomatic reddish vesicles over cheeks, nose, and forehead for four years Figure 1.

Acne vulgaris presents with comedones, papules, and pustules without hyperhidrosis and telangiectasia.

Hyperhidrosis is the initial conspicuous feature of GRN which tends to worsen in summer. Moreover, she showed excellent response to topical tacrolimus, a finding not observed in literature.