Miliaria Differential Diagnoses

Updated: Mar 27, 2020
  • Author: Nikki A Levin, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Diagnostic Considerations

Miliaria crystallina and miliaria rubra are common in infants; therefore, pediatricians must be able to distinguish these conditions from other common eruptions that affect infants.

Miliaria crystallina can be confused with congenital herpes simplex, varicella, syphilis, candidiasis, or staphylococcal scalded skin syndrome. Cytologic findings in the blister fluid should rule out these conditions; cytologic methods may involve Tzanck preparation, Gram staining, and potassium hydroxide preparation, as well as the acquisition of a biopsy sample for histopathologic analysis.

Miliaria rubra can be confused with erythema toxicum neonatorum, infantile acne, or folliculitis. Pustules of erythema toxicum are characteristically filled with eosinophils, unlike those of miliaria rubra. Infantile acne typically involves the face in a follicular distribution. Miliaria may involve the face, as well as the trunk and axillae. Superficial folliculitis, as its name suggests, is follicular, unlike miliaria.

Differential Diagnoses