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For further information, see CMDT Part 6-30: Miliaria (Heat Rash)

Key Features

  • Burning

  • Itching

  • Superficial aggregated small vesicles, papules, or pustules on covered areas of the skin, usually the trunk

  • More common in hot, moist climates

Clinical Findings

  • Burning and itching

  • Lesions consist of small, superficial, red, thin-walled, discrete but closely aggregated vesicles (miliaria crystallina), papules (miliaria rubra), or vesicopustules or pustules (miliaria pustulosa)

  • Differential diagnosis

    • Folliculitis

    • Drug eruption

Diagnosis

  • Clinical

Treatment

  • See Table 6–2

  • Triamcinolone acetonide, 0.1% in Sarna lotion or mid-potency corticosteroid in a lotion or cream applied two to four times daily

  • Secondary infections (superficial pyoderma) are treated with appropriate antistaphylococcal antibiotics

  • Anticholinergic drugs may be helpful in severe cases, eg, glycopyrrolate, 1 mg twice daily orally

Table 6–2.Useful topical dermatologic therapeutic agents.1

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