How To Get Rid Of Allergy Line On Nose

J Dermatol Case Rep. 2010 December xix; 4(3): 36–37.

Atypical "allergic crease"

Yuval Ramot

¹Department of Dermatology, Hadassah-Hebrew University Medical Middle, Jerusalem, Israel

Alex Maly

²Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

Abraham Zlotogorski

¹Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, State of israel

Krassimira Nanova

ⁱⁱⁱKupat Holim Meuhedet, Jerusalem, Israel

Received 2010 May nine; Accepted 2010 December v.

Abstract

Background

The allergic crease (nasal crease) is a transverse line, common among patients who endure from allergic rhinitis. Although information technology is a very prevalent condition, the pare manifestations which accompany this condition have been only sparsely reported.

Main observation

We draw an xviii-year-old man with allergic rhinitis, who adult cornified papules forth an allergic crease. Dermoscopic examination revealed oval, slightly raised, gray, sharply demarcated papules. Histopathology revealed seborrheic keratosis similar hyperplasia, accompanied by horn cysts.

Conclusions

To our knowledge, cornified papules have non been reported previously forth the allergic pucker. Considering the fact that allergic rhinitis is a mutual chronic status of childhood, increased awareness of the skin manifestations which accompany this condition is essential.

Keywords: allergic crease, allergic rhinitis, dermoscopy, pediatric dermatology, seborrheic keratosis like hyperplasia

Introduction

The "allergic crease" (nasal crease) was first described in 1960 by Meyers as a transverse hyperpigmented or hypopigmented skin line, located approximately across the connexion betwixt the lower and eye thirds of the bridge of the nose.[1] Although it may be a congenital, familial abnormality,[2] about of the cases are found in patients with allergic rhinitis.[three] The "allergic crease" together with the "allergic shiner" (concealment of the lower eyelid) and the "allergic salute" constitute the 3 facial hallmarks of these patients. Although it is a very prevalent condition, actualization in 7% of schoolchildren with nasal symptoms and signs of allergic rhinitis,[4] the pare manifestations which accompany this condition have been only sparsely reported.[5,six] We present a patient with small cornified papules which developed along the allergic crease.

Case Report

A 18-yr-old human presented with the gradual appearance of linear pigmentation along the bridge of his nose for several years, accompanied by a recent emergence of pocket-size papules along this line. The lesions were non pruritic, neither were they painful. The patient had a history of allergic rhinitis, with abiding upwards rubbing of his nose (corresponding to the "allergic salute" sign). Other than that, the patient was in good health. The patient was treated with 4% hydroquinone foam, with no apparent improvement. On exam, he was constitute to have a transverse, brown hyperpigmented line across the junction between the lower and heart thirds of the span of the olfactory organ. Along this line several minor cornified papules were apparent [Fig. 1]. Dermoscopy examination revealed oval, slightly raised, gray, sharply demarcated papules and a network of dilated blood vessels [Fig. 2]. Skin biopsy demonstrated a seborrheic keratosis like hyperplasia [Fig. 3A], accompanied by horn cysts with a few melanophages in the dermis [Fig. 3B]. No inflammation was axiomatic.

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Hyperkeratotic papules along a linear transverse hyperpigmented line on the bridge of the olfactory organ. The box indicates the typical expanse of an "allergic crease".

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Dermoscopy shows hyperkeratotic structures with a "yellow dot-like appearance" and a network of multiple dilated blood vessels.

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Histopathology reveals seborrheic keratosis like hyperplasia (A, x40), accompanied by horn cysts with a few melanophages in the dermis (B, x100).

Give-and-take

The nasal crease is probably formed from constant rubbing of the nose in patients suffering from allergic rhinitis. Yet, in addition, this constant rubbing predisposes the patient to other lesions located on the nasal crease. These include hyperpigmentation and hypopigmentation and atrophic scarring.[i] Additionally, the formation of milia has also been described, with pathologic evaluation revealing an epidermal cyst.[5] It has been suggested that the rupture of these cysts leads to keratin penetration into the dermis and the formation of acneiform lesions, histopathologically showing foreign body granulomas with inflammation.[6] These lesions have been termed "pseudoacne of the nasal crease".[6]

The lesions described in the current report are different from the ones reported previously, clinically, dermoscopically and histopathologically. To the best of our noesis, such cornified papules, with histologic appearance resembling seborrheic keratosis, take non been described before along the allergic crease. Considering the fact that allergic rhinitis is considered the most common chronic condition of childhood, with about 40% prevalence,[3] increased awareness of the pare manifestations which back-trail this condition is essential.

References

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