Miliaria describes a group of conditions associated with the retention of sweat in the skin. When the sweat cannot flow from the sweat glands out onto the surface of the skin due to obstruction the results are a variety of signs and symptoms. The location of the trapped sweat in the dermis or epidermis and how it looks determines which of the four types of miliaria that develops. The four types are:
- Miliaria crystalline
- Miliaria rubra
- Miliaria pustulosa
- Miliaria profunda
Miliaria crystalline (also known as sudamina) consists of superficial, noninflammed, subcorneal vesicles that easily rupture when rubbed.
Miliaria rubra (also known as prickly heat) results when the retained sweat moves into the living layers of the epidermis as well as the upper dermis causing itching and an inflammatory response (red skin around the sweat pores). This is particularly common in infants but can also happen in adults after repeated bouts of exposure to a hot, humid environment. Usually the problem goes away or improves within a day or so after entering a cool environment. Sometimes these same miliaria rubra vesicles will become pustular and then it is called miliaria pustulosa.
Miliaria profunda occurs when the retained sweat actually leaks out of the sweat ducts into the dermis of the skin. This can occur during exposure to intense heat resulting in the formation of discrete, flesh colored papules that resemble goose bumps.
Miliaria then is caused by retained sweat at different levels of the sweat gland and its duct. However it is not known exactly why someone will develop one type of miliaria versus another. Nonetheless the treatment is to cool the skin and the person suffering from the condition and to avoid further exposure to the causative environment.
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