Granulosis rubra nasi

Abstract

An 18-year-old man presented with erythematous lesions over the nose of 1 year's duration without sensitivity to sunlight. He was otherwise well and there was no relevant family history. Physical examination showed excessive sweating of the nose, cheeks, and upper lip, and erythema of the nose covered by beads of sweat and vesicles (Fig. 1). The rest of the physical examination was normal. The skin biopsy showed a discrete mononuclear cell perivascular infiltrate.

Diseases of cutaneous appendages

“…1462 Botulinum toxin iontophoresis has been used in the treatment of palmar hyperhidrosis. 1465 Many cases resolve spontaneously at puberty. 1464 Very mild inflammation of the eccrine coils is seen in granulosis rubra nasi, a rare condition with onset in childhood characterized by excessive sweating of the central face, including the nose, with superimposed erythema.…”

Granulosis rubra nasi

“…Erythematous macules, papules, vesicles or even pustules may be seen over the sweat duct orifices. [4] Later numerous small telangiectasias may occur over the nose, cheeks, and chin. [15] Comedo-like lesions may also be present.…”

“…Pilosebaceous units are normal and no heterotopic apocrine glands are found[3] This disease usually remits after puberty, unlike the primary forms of localized hyperhidrosis but sometimes may continue into adulthood. [34] There is neither systemic associations nor abnormal laboratory findings. [3]…”

Treatment of Granulosis Rubra Nasi with Botulinum Toxin Type A

“…Palmoplantar hyperhidrosis and acrocyanosis are sometimes also found in these patients 6 . This disease is usually self‐limiting and resolves at puberty but may persist indefinitely in some cases and cause significant clinical, cosmetic, and psychological complications, such as low self‐esteem 7 …”

“…In many cases, granulosis rubra nasi should be differentiated from inflammatory or photosensitive dermatoses such as rosacea and perioral dermatitis, which are generally diffuse and not associated with hyperhidrosis 1,7 . Other forms of focal hyperhidrosis do not usually show papules, pustules, or telangiectasis.…”