MILIARIA

an inflammatory disorder of human skin, characterized by multiple small lesions at the site of sweat pores, brought about by the blockage of sweat ducts and the resulting escape of sweat into various levels of the skin. Most cases of miliaria occur in extremely hot weather; the lesions tend to disappear with cooler weather and the resultant decrease in sweating. There are four varieties of miliaria. In miliaria crystallina, the sweat escapes into the superficial region of the epidermis, the outermost horny layer of the skin, where it collects in tiny, clear, noninflammatory, dewdrop vesicles (blisters); these are most commonly seen in patients with fever or after a sunburn. Miliaria rubra, or prickly heat, the most common form of sweat retention, results from the escape of sweat into the epidermis, where it produces discrete, densely packed, pinhead vesicles or red papules (solid, usually conical elevations); these lesions occur chiefly on the trunk and extremities, where they cause itching and burning. The incidence of prickly heat is highest in tropical climates, where it most commonly affects infants. In miliaria pustulosa, there are pustules, or small elevations of the skin filled with pus, at the site of sweat retention. Miliaria profunda is a deep type of sweat retention, the sweat escaping into the dermis, the vascular layer of the skin located below the epidermis. The lesions, in this form of miliaria, are firm papules.