Miliaria

Crystallina
NURUL FATEN IZZATI NORHARIZAM
NOVI ANDRIAWATI

C11111842
C11111263

Patients Identity
Name
: Sisilia Jeliman
Gender
: Female
Age
: 21 years old
Marital Status
: Married
Address
: Jl. Andi Tonro
Admission Date : 27 Oktober 2014

History Taking
Chief complaint : red and small vesicles all over
the body and itchy
Happened 1 week ago, started with itch and small red
spots on the face and the neck. By times, it became
small vesicles and started contain pus and spread all
over the body especially at the trunk ,upper and lower
extremities. She had a history of sectio operation 2
months ago.
Fever (-) before lesion appear.

Had history of excessive sweating ,frequently use

thick clothes
First time being infected with this disease.
Contact history : No
Medication history : No medication

Physical Examination
Sclera: Icterus (-)
Conjunctiva: anemia (-)
Lips: cyanosis (-)
Heart/lung: Normal
Abdomen: raised, moving with respiration,
peristaltic (+)
Extremity: Edema (-)
Lymph node: No enlargement.

Current Status
General status

Compos mentis
Mild Sickness
Adequate nutrition
Poor Hygiene

Vital sign

Blood pressure : 120/80 mmHg

Pulse rate
: 76 x/min
Respiration rate : 18 x/min
Temperature
: 37,0 C

Dermato-venerology Status
Location
: Regio Generalisata
Efflorescence : Erythemic papule,
miliaria,
hiperpigmentation,
pustule,
erosion

Recommended examination
Not stated

Resume
A 21 years old woman came to the hospital with
complain of red and small vesicles all over the body and
itchy. It happened 1 week ago started with itch and small
red spots on the face and the neck. By times, it became
small vesicles and started contain pus and spread all over
the body especially at the trunk, upper and lower
extremities. She had a history of sectio operation 2
months ago. She had a history of excessive sweating and
frequently use thick clothes. No medication history.

Diagnosis
D/ Miliaria Crystalina

Treatment
1. Salycyl talc 2% + menthol 1% (all over the
body)
2. Bethamethason + gentamicin cream 1 tube
3. MBS lotion (menthol 0,5% , Boric acid 8%,
Zinc oxide 10%, Spiritus ad. 10%, talc
venetum, aquadest 100 ml)

PICTURES (27-10-2014)

MILIARIA
Disorder of the eccrine sweat glands that often occurs
in condition of increase heat and humidity caused by
blockage of the sweat ducts which results in the
leakge of eccrine sweat into the epidermis or dermis.

Miliaria Crystallina
Miliaria crystallina consists of superficial,
subcorneal, noninflammatory vesicles that
easily
rupture when rubbed with a finger

Epidemiology
Miliaria is most common in tropical
environments
Under chronic and extreme tropical conditions
adults susceptible to miliaria apparently
increases to from 70 to 90%, well over the
40% level of moderately hot conditions

Etiology
Prolonged exposure to a hot, humid
environment, such as exist in the
tropics and in certain occupation,
favors the production of miliaria

Pathogenesis

Sign and Symptoms

Miliaria crystallina, is characterized by minute crystalline
vesicles about 1 mm in diameter, on uninflamed otherwise
normal-looking skin
Miliaria rubra, is the most important clinical form and is
the only type in which the symptom of pruritus is
experienced. The lesions are small erythematous macules
with a punctata vesicle.
Miliaria profunda, ductal obstruction occurs at the
dermal-epidermal junction sweat leaks into the capillary
dermis and produce subtle assymptomatic flash colour
papules.

MILIARIA
CRYSTALLINA

MILIARIA
RUBRA

MILIARIA
PROFUNDA

Diagnosis
Based on clinical manifestation
There are no other cutaneous or laboratory
procedures of diagnostic value

Differential diagnosis

Erythema Toxicum
neonatorum

Folliculitis

Candidiasis

Treatment
TOPICAL drug

1. Salycyl talc 2% + menthol 1% (all over the

body)
2. Bethamethason + gentamicin cream 1 tube
3. MBS lotion (menthol 0,5% , Boric acid 8%,
Zinc oxide 10%, Spiritus ad. 10%, talc venetum,
aquadest 100 ml)

Patients Education
Wear a thin clothes and can absorb sweat
efficiently (cotton)
Protect from sunlight
Avoid physical activity on sunny day
Good ventilation

Prognosis
Miliaria will not remit spontaneously unless a
cool, nonsweating environment is provided
In a hot environment with continued extended
periods of sweating, the miliaria will become
increasingly extensive, eventually involving
enough glands to compromise the temperaturregulating mechanism and lead to a heat stress
syndrome.

THANK YOU