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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The gene locus remains unidentified [ 5 ].

Presentation is common in childhood with a peak age of presentation at 7—12 years, but adolescent and adult onset is also possible. This website is non-profit and holds the images for educational purposes only. The patient gave no history of any treatment taken before. Persistence of inflammation around sweat apparatus prompted us to undertake therapy with topical tacrolimus, considering poor response to topical steroids in past.

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 rura also been reported as effective.

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

The differential diagnosis like rosacea or perioral dermatitis can be considered. These lesions were persistent in nature; however, they used to increase in size on sun exposure and used to get smaller in the shade. Topical tacrolimus has been used in low granulosiss, 0.


It usually resolves at puberty without any sequale. Granulosis rubra nasi is a rare disorder of the eccrine glands, inherited as an autosomal dominant trait.

This is followed by appearance of diffuse erythema over the nose, cheeks, chin, and upper lip. Journal List Dermatol Reports v. Drying lotions like calamine can be tried. Naso erythematous macules, papules, vesicles, or pustules lesions can also be seen [ 28 ]. Da Silva Manzoni, A. As a result of persistent hyperhidrosis, diffuse erythema develops over the tip of the nose.

The patient has been treated with topical tacrolimus 0. 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 ].

Atropine cream was stopped fearing ocular side effects; however, Tacrolimus ointment was continued. It is seen over tip of nose and sometimes, cheeks.


Open in a separate window. It is commonly seen in childhood, but can also occur in adults. In the case of perioral dermatitis there are small monomorphic papules, pustules, erythema, and scaling involving the perioral area and no hyperhidrosis.

On diascopy, lesions used to disappear; however, nasl used to reappear after relieving the pressure.


Diseases of the eccrine and apocrine sweat glands. We hope this case report will prompt other authors to use and document the response of tacrolimus in various stages of GRN. Moreover, she showed excellent response to topical tacrolimus, a finding not observed in literature. Website author — Dr Tim Cunliffe read more. Patient had noticed decreased sweating over the area, once gubra started to appear.

Granulosis rubra nasi

View at Google Scholar C. Some authors have suggested a defect in vasomotor and secretory functions of the nose. This chapter is set out as follows: Folliculitis Folliculitis nares perforans Tufted folliculitis Pseudofolliculitis barbae Hidradenitis Hidradenitis suppurativa Recurrent palmoplantar hidradenitis Neutrophilic eccrine hidradenitis.

In rosacea there is erythema of the cheeks and nose along with telangiectasias but no hyperhidrosis of the central part of the face.

This is a chronic, benign condition of unknown etiology [ 24 ]. GRN is an inflammatory condition involving eccrine sweat glands of nose, cheeks and chin. The skin biopsy showed dilatation of blood vessels, dilated sweat ducts with a discrete mononuclear cell infiltrate surrounding them [ Figure 3 ].