Widespread miliaria crystallina: About a case

Abstract

Prickly heat is a benign cutaneous manifestation due to the obstruction of the sweat ducts following excessive exposure to heat, humidity or hyperthermia. We report the case of a 70-year old diabetic female patient treated with insulin, hospitalized in the Intensive Care Unit due to acidocetosic coma secondary to pyelonephritis. The patient had diffuse clear vesicular lesions spread all over the body,(a) firm to palpation, on a healthy skin, suggesting miliaria crystallina. Miliaria crystallina is a benign cutaneous manifestation due to sweat retention secondary to obstruction of the sweat ducts. It is possible to distinguish between miliaria crystallina due to the obstruction in the stratum corneum, miliaria rubra due to the obstruction within the malpighian stratum and miliaria profunda due to an obstrusction in or below the dermoepidermal junction, depending on the level of obstruction. Miliaria crystallina heals spontaneously in a few hours giving rise to a desquamation, as occurred in our patient after regression of febrile syndrome.