Miliaria (Heat Rash), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
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his book describes Miliaria (Heat Rash), Diagnosis and Treatment and Related Diseases
The weather is hot and I have rashes on my skin.
These rashes are called heat rashes or miliaria.
Miliaria is a frequent skin disease produced by blockage and inflammation of eccrine sweat ducts.
Miliaria is often observed in:
1. Hot, humid or tropical climates,
2. Patients in hospital, and
3. The neonatal period.
Miliaria is also termed sweat rash or prickly heat rash.
Based on the level of the sweat duct obstruction, miliaria can be categorized into 3 subtypes:
1. Miliaria crystallina (sudamina), produced by obstruction of the sweat ducts close to the surface of the skin (epidermis);
2. Miliaria rubra, produced by obstruction of the sweat ducts deeper in the epidermis;
3. Miliaria profunda (tropical anhidrosis), produced by the sweat leaking into the middle layer of skin (dermis).
Miliaria, or eccrine miliaria, is an often observed skin disease activated by blocked eccrine sweat glands and ducts, inducing backflow of eccrine sweat into the dermis or epidermis.
This back flow produces a rash comprising sweat-filled vesicle formation under the skin.
The rash is normally self-limiting and recovers independent of treatment.
Miliaria crystallina is most often observed in neonates with the mean age of 1 week, affecting up to 9% of all neonates.
It can also happen in adults with fever.
Miliaria rubra is the most frequent form of miliaria.
It is observed in children and in up to 30% of adults who travel to a tropical environment or are unexpectedly exposed to heat and humidity.
Miliaria profunda is infrequent and manifests in adult males.
It is a complication of repeated incidents of miliaria rubra.
The main causes are:
1. Immature sweat ducts in a newborn child
2. A hot and humid environment
3. Intense physical activity
4. Fever
5. Occlusion of the skin with non-porous dressings or synthetic clothing against the skin
6. Prolonged bed rest.
Other diseases and treatments that have been linked with miliaria are:
1. Drug-induced hyperhidrosis
2. Adverse reaction to medication (isotretinoin, doxorubicin)
3. Stevens-Johnson syndrome/toxic epidermal necrolysis
4. Genetic disease (Morvan syndrome and pseudohypoaldosteronism type I)
5. Radiotherapy
Any hot or humid conditions and high fevers are linked with miliaria.
These have been identified as causes of miliaria:
1. Occlusion of the skin:
Transdermal drug patches and tight clothing have been linked with miliaria.
2. Type I pseudohypoaldosteronism:
Mineralocorticoid resistance causes loss of sodium through eccrine glands and has been linked with pustular miliaria rubra.
3. Strenuous physical activity:
Exercise increases the amount of sweating
4. Morvan syndrome:
A rare autosomal recessive disease that causes hyperhidrosis, is among other abnormalities, which are prone to miliaria.
5. Medicines:
Drugs that cause sweating such as bethanechol, clonidine, and neostigmine have been linked to miliaria.
Also, few cases of isotretinoin-induced miliaria have been documented.
Miliaria is diagnosed by its characteristic medical manifestation.
In serious cases or repeated episodes, a punch biopsy of the skin can be useful.
Miliaria is a medical diagnosis.
Laboratory tests are often not conclusive and not useful.
Since hot, sweaty situations are the main risk factors for miliaria, the general treatments to decrease sweating and eccrine duct blockage are necessary in the treatment of miliaria.
This involves:
1. Cooler environments,
2. Wearing breathable clothes,
3. Removing skin occluding objects such as band-aids or patches
TABLE OF CONTENT
Introduction
Chapter 1 Miliaria (Heat Rash)
Chapter 2 Causes
Chapt
Kenneth Kee
Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 70. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com This autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 1000 eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical disorders. He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Buona Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. The entire PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"
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Miliaria (Heat Rash), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Miliaria (Heat Rash),
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2020 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes Miliaria (Heat Rash), Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.
(What You Need to Treat Miliaria (Heat Rash))
This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.
This autobiography account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Disorders
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical disorders.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
My diagnosis and treatment capability has improved tremendously from my continued education.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Miliaria (Heat Rash)
The weather is hot and I have rashes on my skin.
What is Miliaria?
Miliaria is a frequent skin disease produced by blockage and inflammation of eccrine sweat ducts.
Miliaria is often observed in:
1. Hot, humid or tropical climates,
2. Patients in hospital, and
3. The neonatal period.
Miliaria is also termed sweat rash or prickly heat rash.
Based on the level of the sweat duct obstruction, miliaria can be categorized into 3 subtypes:
1. Miliaria crystallina (sudamina), produced