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

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

This article has been cited by other articles in PMC. Granklosis dermatitis Granulomatous perioral dermatitis Phymatous rosacea Rhinophyma Blepharophyma Gnathophyma Metophyma Otophyma Papulopustular rosacea Lupoid rosacea Erythrotelangiectatic rosacea Glandular rosacea Gram-negative rosacea Steroid rosacea Ocular rosacea Persistent edema of rosacea Rosacea conglobata variants Periorificial dermatitis Pyoderma faciale.

It runs a chronic course and resolves at puberty without any sequale. After another three months of follow up, patient had not developed any new lesions and had not experienced any significant side effects of Tacrolimus.

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

There is dilation of blood vessels and the lymphatic vessels. There were no other mucocutaneous or systemic features. Topical tacrolimus has been used in low dose, 0. In the English literature Maschkillesson and Neradow have recorded cases and the disease was not thought to be rare.

Granulosis rubra nasi | Primary Care Dermatology Society | UK

He was otherwise well and there was no relevant family history. Histopathology from the vesicle revealed mononuclear cell infiltration in the upper dermis along with dilatation of superficial capillaries and lymphatics Figure 2 A,B.

She had consulted various doctors and was advised many medications, including anti-acne, antibiotic, antifungal and topical steroids, with no benefit. Table of Contents Alerts. In next 1—2 years, she developed small erythematous lesions, which expressed clear and sometimes, granuloais fluid on excoriation, on the central face.


On examination, multiple discrete tense vesicles on an erythematous base were present over central part of face-nose, cheeks and lower part of the forehead Figure 1.

Within 1 year, she developed multiple erythematous papules patient stated lesions did not express fluid or whitish material on excoriation over nose and cheeks.

Case Reports in Dermatological Medicine

Beau’s lines Yellow nail syndrome Leukonychia Azure lunula shape: Pilosebaceous units are normal and no heterotopic apocrine glands are found[ 3 ] This disease usually remits after puberty, unlike graulosis primary forms grxnulosis localized hyperhidrosis grsnulosis sometimes may continue into adulthood. A year-old man presented with erythema over the nose since childhood without sensitivity to sunlight. We are not in a position to comment on the response of tacrolimus in earlier stages of disease process, when hyperhidrosis is prominent as we got the patient in a very late stage.

We hope this case report will prompt other authors to use and document the response of tacrolimus in various stages of GRN. One should remember that it could be a complication of hyperhidrosis. Patient had noticed decreased sweating over the area, once vesicles started to appear. A Patchy mononuclear cell infiltration in upper dermis with dilatation of capillaries and lymphatics Haematoxylin and Eosin stain x ; B patchy mononuclear cell infiltration with dilatation of capillaries and lymphatics Haematoxylin rubfa Eosin stain x ; C mononuclear cell infiltration around sweat duct Haematoxylin and Eosin stain x On second follow up after another one month, patient was almost lesion free, with only few vesicles persisting Figure 3.

Granhlosis 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 ].

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. To the best of our knowledge, there are not any case reports showing GRN with sebaceous gland hyperplasia.

The infundibular and sebaceous ducts are plugged with stratum corneum and villous hair follicles. Views Read Edit View history. The pathogenesis is unknown. It usually presents in childhood between 6 months and 15 years of age. Owing to scarcity granulodis literature, ribra could not ascertain if other authors have had similar observation of decreased sweating in late stages.


Barber had suggested involvement of adenoids, which can provide a source of irritation at the tip of the nose [ 12 ]. The epidermis, connective tissue and pilosebaceous apparatus are otherwise normal and no heterotopic apocrine glands are found. Rarely small comedo like lesions may be present [ 2 ]. Recently, use of botulinum toxin A that induced long-term remission in a patient with GRN was described by Grazziotin et al.

Erythematous macules, papules, vesicles or even pustules may be seen over the sweat duct orifices. Indian Dermatol Online J. Counseling the patients about the self-limiting nature of the condition is of paramount importance.

Andrews’ Diseases of the Skin: It is rare with autosomal granulosix or autosomal recessive pattern of inheritance. Treatment of granulosis rubra nasi with botulinum toxin type A. She had first noticed redness and increased sweating over central face 10 grnaulosis back. Triangular alopecia Frontal fibrosing alopecia Marie Unna hereditary hypotrichosis.

Indian J Dermatol Venereol Leprol. To receive news and publication updates for Case Reports in Dermatological Medicine, enter your email address in the box below.

Granulosis rubra nasi is a rare condition characterised by hyperhidrosis of the nose. Diseases of the skin appandages. Hence reassurance is what is needed. The histopathology report showed epidermal hyperplasia with spongiosis. This is an open access article distributed under the Ansi Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC.