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2.1
Miliaria
Heat Rash

Images

WIKIDATA, CC BY-SA 3.0

Presentation

Miliaria profunda is rare and presents in adult males. It is a complication of repeated episodes of miliaria rubra. What causes miliaria? Miliaria results from sweating. [dermnetnz.org]

We describe here a patient with extensive miliaria crystallina that was present at birth and review possible theories of the pathogenesis of these lesions. [ncbi.nlm.nih.gov]

Miliaria rubra was present in 4% of the neonates, with a mean age of 11-14 days. [emedicine.medscape.com]

Entire Body System

  • Fever

    Five days into her fevers, she developed diffuse, nonpruritic and fragile vesicles together with drenching nightsweats. The patient's exanthem was diagnosed as Miliaria crystallina, most probably induced by neutropenic fever and idarubucin exposure. [ncbi.nlm.nih.gov]

  • Swelling

    Check if you have heat rash The symptoms of heat rash are: small red spots an itchy, prickly feeling redness and mild swelling The symptoms are often the same in adults and children. [nhs.uk]

    Affected individuals should also consult a physician if they notice any signs of infection such as: Increased pain, swelling, warmth or redness in affected area Pus oozing from lesions Development of fever or chills Swollen lymph nodes in the armpit, [news-medical.net]

    Call your child's doctor if the area develops pus, redness, crusting, swelling, or tenderness. In cases of heat exhaustion, the skin will appear hot and flushed without any sweat. [skinsight.com]

    The spots sometimes look like tiny blisters and can cause: mild swelling itching a stinging or intense prickling sensation Causes of prickly heat Prickly heat usually develops when a person sweats more than usual, such as during hot or humid weather. [beaconmedicalgroup.nhs.uk]

  • Disability

    Miliaria profunda is an uncommon but highly characteristic disorder that can be disabling. We describe a patient with miliaria profunda who responded to therapy with anhydrous lanolin and isotretinoin. [ncbi.nlm.nih.gov]

    Please enable JS and disable any ad blocker [aocd.org]

    The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed. Similar articles Heat exhaustion in a deep underground metalliferous mine. Donoghue AM, Sinclair MJ, Bates GP. [pubmed.ncbi.nlm.nih.gov]

    However, severe cases can last for weeks and cause significant disability. [en.wikipedia.org]

Skin

  • Papule

    It causes papules that are larger and more deeply seated than those of miliaria rubra. Papules are frequently painful. [msdmanuals.com]

    Papules can occur within days of exposure, but tend to appear after months. Itching and stinging are the main symptoms caused by the small papules. Efforts aimed at reducing sweating helps resolve the lesions within days. [dermpathdiagnostics.com]

  • Skin Disease

    On DermNet NZ Disorders of sweating Blistering skin conditions Other websites Dermatologic Manifestations of Miliaria – Medscape Reference Patient information: Heat rash (prickly heat) (The Basics) – UpToDate (for subscribers) Books about skin diseases [dermnetnz.org]

    […] layer of skin. [britannica.com]

    […] sostantivo an acute skin disease resulting from inflammation of the sweat glands, as from exposure to heat, and characterized by small, white or red eruptions Webster’s New World College Dictionary, 4th Edition. [collinsdictionary.com]

  • Anhidrosis

    Experimental production in volunteers. ( 6062874 ) SULZBERGER M.B....Wiley H.S. 1967 47 Miliaria and anhidrosis. II. [malacards.org]

    This form of miliaria is often associated with anhidrosis of the affected skin and can result in heat exhaustion. The main treatment of choice for all forms of miliaria is placement of the patient in a cool environment. [bestpractice.bmj.com]

    Tropical anhidrotic asthenia is a skin condition, a rare form of miliaria, with long-lasting poral occlusion, which produces anhidrosis and heat retention. [en.wikipedia.org]

    Anhidrosis develops in the affected sites and may last weeks. If generalized, anhidrosis can lead to hyperpyrexia and heat exhaustion. [emedicine.medscape.com]

  • Erythema

    Miliaria crystallina involves the stratum corneum, producing clear vesicles without erythema. [stanfordmedicine25.stanford.edu]

    Background erythema is often present. In children, miliaria involves the trunk and the skin folds of the neck, axilla or groin. [dermnetnz.org]

    Erythema toxicum neonatorum, neonatal pustular melanosis, and childhood acropustulosis show pustules in contrast to the vesicles of miliaria crystallina which demonstrate clear, water-like fluid. [psychiatryadvisor.com]

  • Dermatitis

    Seborrheic dermatitis is extremely common and should be distinguished from atopic dermatitis. [aafp.org]

    Given the differential diagnoses, which included eczema, these specimens were diagnosed as spongiotic dermatitis compatible with eczema. [jamanetwork.com]

    Contact dermatitis. Mayo Clinic; 2021. AskMayoExpert. Poison ivy allergic contact dermatitis. Mayo Clinic; 2021. Sutaria N, et al. Itch in skin of color: A multicenter cross-sectional study. British Journal of Dermatology. doi:10.111/BJD.20403. [mayoclinic.org]

    Some authors believe that subclinical miliaria is an initiating step in development of atopic dermatitis. [emedicine.medscape.com]

Treatment

Treatment of miliaria may include: Cool water compresses Calamine lotion to relieve discomfort; because of its drying effect, an emollient may be required. [dermnetnz.org]

We present a case of extensive, widespread miliaria crystallina that developed in a newborn during treatment of severe hypernatremic dehydration. [ncbi.nlm.nih.gov]

Prognosis

Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology Histopathology History and Physical Evaluation Treatment / Management Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare [pubmed.ncbi.nlm.nih.gov]

Prognosis Most patients recover uneventfully within a matter of weeks, once they move to a cooler environment. The complications of miliaria are altered heat regulation and secondary infection (see Complications). [emedicine.medscape.com]

Folliculitis, whether bacterial or pityrosporum Neonatal acne or erythema toxicum neonatorum Drug rashes, particularly acute, generalized, exanthematous pustulosis Grover disease Arthropod bites Lymphocytoma cutis or cutaneous T-cell pseudolymphomas Prognosis [ncbi.nlm.nih.gov]

Part I of this article reviews the presentation, prognosis, and treatment of the most common rashes that present during the first four weeks of life. [aafp.org]

Etiology

An historical review of the causation of miliaria. ( 15437051 ) 1950 23 The etiology of poral closure. II. [malacards.org]

These can help distinguish miliaria from infectious etiologies. The initial, well-formed vesicles can be seen on the right side of the image while the later stage flaccid, ruptured vesicles are pictured on the left. [stanfordmedicine25.stanford.edu]

Epidemiology Occurs in as many as 30% of people who move to tropical climates Etiology Sweat leaks into the subcorneal layers because of ductal blockage Pathogenesis Sweat goes into the epidermis and upper dermis causing inflammation around the pores [dermpathdiagnostics.com]

Etiology Eccrine ducts in newborns are relatively immature, thus predisposing to pore blockage and sweat retention. Miliaria crystallina results from superficial obstruction at the level of the stratum corneum. [psychiatryadvisor.com]

The exact etiology of seborrheic dermatitis is unknown. [aafp.org]

Epidemiology

Definition / general Obstruction of sweat gland ducts during high heat and humidity Epidemiology Most often seen in children, but may affect any age Clinical features Miliaria crystallina: obstruction is within stratum corneum, resulting in small clear [pathologyoutlines.com]

Epidemiology Occurs in as many as 30% of people who move to tropical climates Etiology Sweat leaks into the subcorneal layers because of ductal blockage Pathogenesis Sweat goes into the epidermis and upper dermis causing inflammation around the pores [dermpathdiagnostics.com]

Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology Histopathology History and Physical Evaluation Treatment / Management Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare [pubmed.ncbi.nlm.nih.gov]

Ultraviolet radiation: Some researchers found that miliaria crystallina preferentially occurs in UV-exposed skin. [17] Epidemiology Frequency United States Miliaria crystallina is a common condition that occurs in neonates, with a peak in those aged 1 [emedicine.medscape.com]

Pathophysiology

Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology Histopathology History and Physical Evaluation Treatment / Management Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare [pubmed.ncbi.nlm.nih.gov]

Because the pathophysiology involves the stratum corneum or the most superficial layer of the outer layer of the skin, the vesicles have a thin superficial layer that results in the vesicles resembling water droplets on the skin that easily rupture. [ [ncbi.nlm.nih.gov]

Pathophysiology An extracellular polysaccharide substance produced by Staphylococcus epidermidis has been theorized to play a role in the pathogenesis of miliaria by occluding sweat ducts. [psychiatryadvisor.com]

Pathophysiology The primary stimuli for the development of miliaria are conditions of high heat and humidity that lead to excessive sweating. [emedicine.medscape.com]

Prevention

How to prevent heat rash in babies Here are a few tips to prevent heat rash in your baby: Avoid heavy clothing and too much time in a carrier or sling, where the combination of your body heat and poor ventilation can keep your little one sweltering. [whattoexpect.com]

Once the diagnosis has been established, cooling measures and prevention of further sweating is indicated to prevent progression or hyperpyrexia. Improvement is generally seen over hours to days with these measures. [psychiatryadvisor.com]

Self-Care Guidelines Prevention and treatment of heat rash consist of controlling heat and humidity. Acetaminophen or ibuprofen can help to reduce fever. [skinsight.com]

Treatment and Prevention Move to a cooler, less humid place. Don’t scratch your skin, or it could become infected. Keep the affected area dry. Don’t use ointments or creams that keep your skin moist. [webmd.com]

How can it be prevented? Avoiding excess heat and humidity is the best way to prevent miliaria. [drgreene.com]

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