Granulosis rubra nasi

Granulosis Rubra Nasi

Granulosis Rubra Nasi - a rare chronic disorder characterized by the appearance of red nodules on the skin of the nose. ICD-10 Code: L74.8

It occurs mainly in children and adolescents, slightly more often in girls; cases in adults are rare.

The etiology and pathogenesis of the disease are unknown. It is thought to be a genetic dermatosis with autosomal dominant inheritance, associated with angioneurosis and neuroendocrine disorders, often typical of adolescence. Tuberculosis intoxication, chronic upper respiratory tract disease, and vasomotor disorders have been implicated.

On the reddened, sometimes bluish skin of the nose, especially on its tip and wings, and in some cases on the cheeks and upper lip, less commonly on the chin and forehead, there are scattered, soft, round and conical, pink and bluish red nodules, ranging in size from a pinpoint to a pinhead. The nodules do not coalesce or itch; vesiculation is sometimes observed on the surface of some nodules; pustules are extremely rare. Intense hyperhidrosis of the nasal skin is always present (small droplets of sweat resembling dew).

During emotional stress, the redness of the nose intensifies; the nose remains cold even in hot weather. Non-specific changes in the mucous membrane of the tongue are observed. The disease is accompanied by generalized hyperhidrosis, sometimes only hyperhidrosis of the palms and soles, and hypertrichosis. In the absence of subjective sensations, the condition can be considered a cosmetic defect.

Diagnosis is not difficult. In doubtful cases, the diagnosis can be confirmed by histologic examination.

  • Papular sarcoidosis
  • Rosacea
  • Bromide (iodide) acne

The prognosis is good. In most cases, eruptions resolve by sexual maturity. Topical treatments include ointments containing ichthammol and glucocorticoids (2-3%), cryotherapy with liquid nitrogen, and electrocoagulation. Successful topical application of calcineurin inhibitors (tacrolimus) has been reported.