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May 1992

Nose Sign of Exfoliative Dermatitis: A Possible Mechanism

Author Affiliations

Banglow No. 3 Medical College Campus Jodhpur-342003 Rajasthan, India

Arch Dermatol. 1992;128(5):704. doi:10.1001/archderm.1992.01680150138029

To the Editor.—  The term exfoliative dermatitis is used to refer to any inflammatory skin condition affecting more than 90% of body surface area with erythema and scaling.1During a 2-year period, we examined 20 patients with exfoliative dermatitis of varied pathogenesis. Thirteen patients were clearly exhibiting nose sign, ie, sparing of the nose and the paranasal area.Although the clinical features of exfoliative dermatitis have been described in detail in the major textbooks of dermatology, no discussion has been presented about nose sign.It was reported by Pavithran,2 but no explanation was put forward regarding its mechanism. In our opinion, a possible mechanism of nose sign may be the following: relatively more sun exposure to this area, which might have some ameliorating effect due to its presumptive antimitotic action3; or frequently blowing or rubbing one's nose due to a "nervous habit," both of which help to

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