Last reviewed: November 2017
Last updated: September  2017

Summary

Definition

History and exam

Key diagnostic factors

  • nonfollicular vesicles and papules (all types)
  • asymptomatic eruption (crystallina)
  • clear noninflammatory vesicles (crystallina)
  • fragile vesicles (crystallina)
  • paroxysmal pruritus and stinging (rubra)
  • erythematous papulovesicles (rubra)
  • anhidrosis (profunda)
  • compensatory hyperhidrosis (profunda)
  • flesh-colored papules (profunda)

Other diagnostic factors

  • desquamative healing (crystallina)
  • weakness and malaise (profunda)
  • dyspnea (profunda)
  • tachycardia (profunda)
  • hyperpyrexia (profunda)

Risk factors

  • profuse sweating
  • excessive heat and humidity
  • occlusive clothing
  • febrile illness
  • repeat episodes of miliaria rubra (for miliaria profunda)
  • ultraviolet light exposure
  • neonatal age
  • cholinergic medications
  • isotretinoin
  • doxorubicin
  • staphylococcal scalded skin syndrome
  • atopic dermatitis

Diagnostic investigations

Investigations to consider

  • Tzanck smear
  • viral direct fluorescent antibody (DFA) or culture
  • viral PCR
  • bacterial culture
  • fungal culture
  • KOH prep
  • skin biopsy
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Brian L. Swick

Clinical Associate Professor

Departments of Dermatology and Pathology

Iowa City Veterans Affairs Medical Center

Iowa City

IA

Disclosures

BLS declares that he has no competing interests.

Peer reviewers VIEW ALL

Dermatology Physician

Town Square Dermatology

Coralville

IA

Disclosures

HWW declares that he has no competing interests.

Consultant Dermatologist

Department of Dermatology

Queen's Medical Centre

Nottingham University Hospitals

Nottingham

UK

Disclosures

JE declares that he has no competing interests.

Consultant Dermatologist

Yadkin Valley Dermatology

Affiliate of Hugh Chatham Memorial Hospital

Elkin

NC

Disclosures

ADL declares that he has no competing interests.

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