MILIARIA- SKIN DISORDER

INTRODUCTION
“Miliaria” is the general term used to describe conditions caused by blockage within the sweat duct. Eccrine miliaria is a common, transient cutaneous disorder caused by blockage within the eccrine sweat duct. It is also known as “sweat rash,” “prickly heat,” or “heat rash.”
CAUSES:
Anything that causes sweating can lead to eccrine miliaria in infants, children, and adults. Common causes include:
●Hot and humid environments
●Strenuous physical activity
●Febrile illness [6]
●Occlusion of the skin
CLINICAL MANIFESTATIONS
The clinical features of miliaria crystallina, miliaria rubra, and miliaria profunda are reviewed below:
●Miliaria crystallina – Results from superficial blockage of the sweat duct (within the stratum corneum) and is characterized by superficial, clear 1 to 2 mm vesicles that resemble water droplets. The vesicles may coalesce. Due to their superficial location, the vesicles rupture easily and do not cause a significant inflammatory response.


●Miliaria rubra – Results from blockage of the duct, usually within the epidermis, although it can occur in the dermis. Leakage of sweat causes inflammation in the periductal tissue. Miliaria rubra is characterized by erythematous 2 to 4 mm papules. They may be papulovesicular or pustular.


●Miliaria profunda – Caused by blockage deeper within the sweat duct (at the dermal-epidermal junction or below). It usually occurs after repeated episodes of miliaria rubra. Escape of sweat into the surrounding tissues results in erythematous to skin-colored, firm papules 1 to 4 mm in diameter. The papules are non-follicular. It is most common in adult males, especially military personnel stationed in tropical climates
Seen most in adults, miliaria profunda usually occurs on the trunk but can be seen on the extremities as well. Because sweat is obstructed deeply within the skin, affected areas show little or no sweating. The eruption is typically asymptomatic. It may also be subtle and become more visible when the patient sweats.


●Management
•General measures –
Treatment of miliaria revolves around minimizing exposure to factors that stimulate sweating and occlusion of eccrine sweat glands. This approach includes the following measures:
-Move patient to a cooler environment if possible
-Wear breathable clothing (such as cotton) that does not occlude the skin
-Remove occlusive bandages or medication patches in the affected area and use more porous alternatives if needed
-Treat fever with antipyretics