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miliaria crystallina
Etiology:
1) mild damage to the keratin layer of the epidermis
2) mild thermal injury or sunburn
3) in infants, miliaria crystallina may result from immature sweat glands
4) may occur after phototherapy
5) prolonged supine position [2]
Pathology:
1) sloughing of keratin & clogging of sweat pores
2) thin-walled vesicles may be seen with sweating
3) inflammation is minimal
Clinical manifestations:
1) generally asymptomatic & very rarely causes clinical problems
2) fragile 2-3 mm thin walled vesicles
3) distribution:
a) face
b) neck
c) upper trunk
4) no associated erythema
5) may occur in areas of desquamating sunburn
* images (see miliaria)
Laboratory: not useful in diagnosis of miliaria
Management: (common to all forms of miliaria)
1) moving to cooler environment
2) application of cool compresses
3) wearing light, loose-fitting clothing
4) avoidance of greasy topical agents
5) natural desquamation
6) ensure adequate hydration
General
miliaria (heat rash, sweat rash)
References
- Saunders Manual of Medical Practice, Rakel (ed),
WB Saunders, Philadelphia, 1996, pg 926
- Medical Knowledge Self Assessment Program (MKSAP) 16, 17
American College of Physicians, Philadelphia 2012, 2015
- Haas N, Martens F, Henz BM
Miliaria crystallina in an intensive care setting.
Clin Exp Dermatol. 2004 Jan;29(1):32-4
PMID: 14723716