Last reviewed: 30 Sep 2024
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
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
Disclosures
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
Disclosures
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
Disclosures
ADL declares that he has no competing interests.
Differentials
- Fox-Fordyce disease (apocrine miliaria)
- Primary varicella infection
- Disseminated varicella-zoster infection
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