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Miliaria

Last reviewed: 20 Aug 2025
Last updated: 18 Jan 2023

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)
Full details

Other diagnostic factors

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

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
Full details

Diagnostic tests

Tests to consider

  • Tzanck smear
  • viral direct fluorescent antibody (DFA) or culture
  • viral polymerase chain reaction
  • bacterial culture
  • fungal culture
  • potassium hydroxide (KOH) prep
  • skin biopsy
Full details

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Brian L. Swick, MD
Brian L. Swick

Clinical 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

Hobart W. Walling, MD, PhD

Dermatology Physician

Town Square Dermatology

Coralville

IA

Declarações

HWW declares that he has no competing interests.

John English, MBBS, FRCP

Consultant Dermatologist

Department of Dermatology

Queen's Medical Centre

Nottingham University Hospitals

Nottingham

UK

Divulgaciones

JE declares that he has no competing interests.

Andrew D. Lee, MD, FAAD

Consultant Dermatologist

Yadkin Valley Dermatology

Affiliate of Hugh Chatham Memorial Hospital

Elkin

NC

Divulgaciones

ADL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Wenzel FG, Horn TD. Nonneoplastic disorders of the eccrine glands. J Am Acad Dermatol. 1998 Jan;38(1):1-17; quiz 18-20. Resumen

Artículos de referencia

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