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granulosis rubra nasi is a rare disorder of the eccrine glands first described by jadassohn in 1901 .
 it is thought to be common in european countries . in the english literature maschkillesson and neradow ( 1935 )
have recorded 130 cases and the disease was not thought to be rare . although it is inherited as an autosomal dominant trait , it is rare to find the disease in two generations , although less commonly it is found in two children of same parents .
granulosis rubra nasi is a focal form of hyperhidrosis that differs from the other forms in that it does not depend on the hypothalamic or emotional stimuli to develop .
a 27-year - old man presented with erythema over the nose since childhood without sensitivity to sunlight .
physical examination showed excessive sweating of the nose , erythema of the nose covered by beads of sweat , and multiple telangiectatic vesicles [ figures 1 and 2 ] .
the skin biopsy showed dilatation of blood vessels , dilated sweat ducts with a discrete mononuclear cell infiltrate surrounding them [ figure 3 ] .
beads of sweat seen on an erythematous base over the nose shows erythema more prominently .
telangiectasias are appreciable histopathology section showing dilated blood vessels and eccrine ducts with surrounding lymphocytic infiltrate [ h & e , 10x ]
the clinical picture is characterized by hyperhidrosis of the central part of the face , most conspicuous on the tip of the nose .
this is followed by appearance of diffuse erythema over the nose , cheeks , chin , and upper lip .
erythematous macules , papules , vesicles or even pustules may be seen over the sweat duct orifices . later
histopathology shows a mild mononuclear cell infiltrate around the sweat ducts , blood vessels , and lymphatics .
pilosebaceous units are normal and no heterotopic apocrine glands are found this disease usually remits after puberty , unlike the primary forms of localized hyperhidrosis but sometimes may continue into adulthood .
some authors have suggested that it is a disorder of vasomotor and secretory function of the nose .
eddowes had suggested that adenoids could be involved which can provide a source of irritation to the tip of the nose .
reported a case of granulosis rubra nasi associated with phaeochromocytoma , surgical removal of which was followed by regression of the condition .
the clinical picture is very distinctive and rarely there is a problem with the diagnosis .
there is erythema of the cheeks and nose along with telangiectasias but no hyperhidrosis of the central part of the face . in the case of perioral dermatitis
there are small monomorphic papules , pustules , erythema , and scaling involving the perioral area and no hyperhidrosis .
treatment of granulosis rubra nasi has been described in the literature with topical indomethacin , oral corticosteroids , tetracycline , cryotherapy , and even x - rays .
have recently described a treatment using botulinum toxin a that induced long - term remission in a patient with granulosis rubra nasi .
granulosis rubra nasi is a rare disorder of the eccrine glands , inherited as an autosomal dominant trait . 
 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 . 
 it is commonly seen in childhood , but can also occur in adults . 
 this is a case report of a 27-year - old male patient who presented with excessive sweating over the nose . 
 physical examination of the nose revealed erythema and multiple telangiectatic vesicles . 
 biopsy findings supported the diagnosis of granulosis rubra nasi . 
 this case is being reported for its rarity since to the best of our knowledge , it has not been reported in indian subjects so far .