Dermatologic Manifestations of Miliaria Follow-up

  • Author: Nikki A Levin, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Mar 1, 2012
 

Deterrence/Prevention

Patients should avoid exposure to conditions of high heat and humidity.

When patients are in tropical climates, they should wear lightweight clothing, avoid exertion, use sunscreen, and stay in air-conditioned buildings as much as possible.

In patients with a history of miliaria, the application of topical anhydrous lanolin before exercise may help prevent the formation of new lesions.

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Complications

The most common complications of miliaria are secondary infection and heat intolerance.

Secondary infection may appear as impetigo or as multiple discrete abscesses known as periporitis staphylogenes.

Heat intolerance is most likely to develop in patients with miliaria profunda; it is recognized by anhidrosis of the affected skin, weakness, fatigue, dizziness, and even collapse. In its most severe form, this heat intolerance is known as tropical anhidrotic asthenia.

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Prognosis

Most patients recover uneventfully within a matter of weeks, once they move to a cooler environment.

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Patient Education

Patients who have had miliaria, especially miliaria profunda, must be aware of the role of heat and humidity in precipitating this condition.

These patients should be advised to wear lightweight clothing, stay out of the sun, avoid exertion in hot weather, and stay in an air-conditioned environment as much as possible.

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Contributor Information and Disclosures
Author

Nikki A Levin, MD, PhD  Associate Professor of Medicine, Division of Dermatology, University of Massachusetts Medical School

Nikki A Levin, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Phi Beta Kappa, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Janet Fairley, MD  Professor and Head, Department of Dermatology, University of Iowa, Roy J and Lucille A Carver College of Medicine

Janet Fairley, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Federation for Medical Research, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD  Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology

Disclosure: Lippincott Williams Wilkins Royalty Textbook editor; DLA Piper Consulting fee Consulting

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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  5. Mowad CM, McGinley KJ, Foglia A, Leyden JJ. The role of extracellular polysaccharide substance produced by Staphylococcus epidermidis in miliaria. J Am Acad Dermatol. Nov 1995;33(5 Pt 1):729-33. [Medline].

  6. Hidano A, Purwoko R, Jitsukawa K. Statistical survey of skin changes in Japanese neonates. Pediatr Dermatol. Feb 1986;3(2):140-4. [Medline].

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  10. Arpey CJ, Nagashima-Whalen LS, Chren MM, Zaim MT. Congenital miliaria crystallina: case report and literature review. Pediatr Dermatol. Sep 1992;9(3):283-7. [Medline].

  11. Straka BF, Cooper PH, Greer KE. Congenital miliaria crystallina. Cutis. Feb 1991;47(2):103-6. [Medline].

  12. Haas N, Henz BM, Weigel H. Congenital miliaria crystallina. J Am Acad Dermatol. Nov 2002;47(5 Suppl):S270-2. [Medline].

  13. Doshi BR, Mahajan S, Kharkar V, Khopkar US. Granulomatous Variant of Giant Centrifugal Miliaria Profunda. Pediatr Dermatol. Jan 26 2012;[Medline].

  14. Carter R 3rd, Garcia AM, Souhan BE. Patients presenting with miliaria while wearing flame resistant clothing in high ambient temperatures: a case series. J Med Case Reports. 2011;5(1):474. [Medline].

  15. Argoubi H, Fitchner C, Richard O, Lavocat MP, Cambazard F, Stephan JL. [Pustular miliaria rubra and systemic type 1b pseudohypoaldosteronism in a newborn]. Ann Dermatol Venereol. Mar 2007;134(3 Pt 1):253-6. [Medline].

  16. Urbatsch A, Paller AS. Pustular miliaria rubra: a specific cutaneous finding of type I pseudohypoaldosteronism. Pediatr Dermatol. Jul-Aug 2002;19(4):317-9. [Medline].

  17. Akcakus M, Koklu E, Poyrazoglu H, Kurtoglu S. Newborn with pseudohypoaldosteronism and miliaria rubra. Int J Dermatol. Dec 2006;45(12):1432-4. [Medline].

  18. Tabanelli M, Passarini B, Liguori R, Balestri R, Gaspari V, Giacomini F, et al. Erythematous papules on the parasternal region in a 76-year-old man. Clin Exp Dermatol. May 2008;33(3):369-70. [Medline].

  19. Haas N, Martens F, Henz BM. Miliaria crystallina in an intensive care setting. Clin Exp Dermatol. Jan 2004;29(1):32-4. [Medline].

  20. Gupta AK, Ellis CN, Madison KC, Voorhees JJ. Miliaria crystallina occurring in a patient treated with isotretinoin. Cutis. Oct 1986;38(4):275-6. [Medline].

  21. Godkar D, Razaq M, Fernandez G. Rare skin disorder complicating doxorubicin therapy: miliaria crystallina. Am J Ther. May-Jun 2005;12(3):275-6. [Medline].

  22. Shuster S. Duct disruption, a new explanation of miliaria. Acta Derm Venereol. Jan 1997;77(1):1-3. [Medline].

 
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Miliaria crystallina in an infant. Note that the lesions are confluent. Courtesy of K.E. Greer, MD.
Miliaria rubra in an adult. Courtesy of K.E. Greer, MD.
Miliaria pustulosa. Courtesy of K.E. Greer, MD.
Miliaria crystallina. Note the water-drop appearance of the lesions. Courtesy of K.E. Greer, MD.
Miliaria crystallina in a newborn child. Courtesy of K.E. Greer, MD.
Miliaria pustulosa. Courtesy of K.E. Greer, MD.
 
 
 
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