[A newborn with blisters]. / Een neonaat met blaasjes.

This case concerns a newborn with many small transparent vesicles on the forehead, trunk and face. Miliaria crystallina was diagnosed based on the typical presentation. Miliaria crystalline is a transient obstruction of sweat glands resulting in non-inflammatory vesicles. The treatment is simple: cool down.

The Infectious and Noninfectious Dermatological Consequences of Flooding: A Field Manual for the Responding Provider.

Meteorological data show that disastrous floods are increasingly frequent and more severe in recent years, perhaps due to climatic changes such as global warming. During and after a flood disaster, traumatic injuries, communicable diseases, chemical exposures, malnutrition, decreased access to care, and even mental health disorders dramatically increase, and many of these have dermatological manifestations. Numerous case reports document typical and atypical cutaneous infections, percutaneous trauma, immersion injuries, noninfectious contact exposures, exposure to wildlife, and exacerbation of underlying skin diseases after such disasters as the 2004 Asian tsunami, Hurricane Katrina in 2005, and the 2010 Pakistan floods. This review attempts to provide a basic field manual of sorts to providers who are engaged in care after a flooding event, with particular focus on the infectious consequences. Bacterial pathogens such as Staphylococcus and Streptococcus are still common causes of skin infections after floods, with atypical bacteria also greatly increased. Vibrio vulnificus is classically associated with exposure to saltwater or brackish water. It may present as necrotizing fasciitis with hemorrhagic bullae, and treatment consists of doxycycline or a quinolone, plus a third-generation cephalosporin and surgical debridement. Atypical mycobacterial infections typically produce indolent cutaneous infections, possibly showing sporotrichoid spread. A unique nontuberculous infection called spam has recently been identified in Satowan Pacific Islanders; combination antibiotic therapy is recommended. Aeromonas infection is typically associated with freshwater exposure and, like Vibrio infections, immunocompromised or cirrhotic patients are at highest risk for severe disease, such as necrotizing fasciitis and sepsis. Various antibiotics can be used to treat Aeromonas infections. Melioidosis is seen mainly in Southeast Asia and Australia, particularly in rice farmers, and can remain latent for many years before presenting as the host's immunocompetence wanes. It can present with a variety of skin findings or as a nonspecific febrile illness, and preferred treatment consists of ceftazidime or a carbapenem with trimethoprim/sulfamethoxazole (TMP/SMX) for 2 weeks, then continuing TMP/SMX for at least 3 months. Leptospirosis is a waterborne zoonosis that is often prevalent after heavy rains or flooding. Different forms exist, including Fort Bragg fever, which produces a distinctive erythematous papular rash on the shins. Doxycycline is often sufficient; however, volume and potassium repletion may be necessary if renal involvement exists. Chromobacterium violaceum infection may occur after open skin is exposed to stagnant or muddy water. Cultured colonies produce a unique violacein pigment, and treatment typically consists of a carbapenem. Both typical and atypical fungal infections are increased in the flooding disaster scenario, such as dermatophytosis, chromoblastomycosis, blastomycosis, and mucormycosis. Appropriate antifungals should be used. In addition, land inundated with water expands the habitat for parasites and/or vectors, thus increased vigilance for regional parasitic infections is necessary after a flood. Lastly, noninfectious consequences of a flooding disaster are also common and include miliaria, immersion foot syndromes, irritant and allergic contact dermatitis, traumatic wounds and animal bites, and arthropod assault, as well as exacerbation of existing skin conditions such as atopic dermatitis, psoriasis, and alopecia areata due to increased stress or nonavailability of daily medications.

Environmental illness in athletes.

This article examines environmental illness in athletes. Causes, symptoms, and treatment of heat-related illness, cold-related illness, and altitude-related illness are discussed.

Miliaria crystallina in an intensive care setting.

Drop-like, transient blisters of miliaria crystallina may develop with focal intensity of heat within the skin, such as occurs in tropical climates or during febrile episodes. Miliaria crystallina develops due to a transient poral closure of the sweat duct opening, resulting in obstruction of free flow of eccrine sweat and retention in a vesicle below the skin surface. Dual cholinergic and adrenergic sweat gland innervation is influenced by a variety of medications used in intensive care patients. We present two febrile intensive care patients in whom enhanced alpha-adrenergic stimulation of sweat gland myoepithelia may have led to miliaria crystallina.

Congenital miliaria crystallina.

Miliaria crystallina is a transient, superficial obstruction of eccrine sweat ducts resulting in rapidly evolving noninflammatory vesicles. The disease is observed frequently in hot, humid, tropical climates and in the neonatal period, but congenital occurrence is very rare. Miliaria crystallina must be considered in the differential diagnosis of bullous diseases in newborns.

Miliaria rubra / Miliaria rubra

La miliaria es una erupción que afecta predominantemente a los neonatos y a la primera infancia, se produce por obstrucción del poro sudoríparo y, en su aparición, intervienen factores como exceso de sudación infecciones superficiales y aplicación de cremas. Dependiendo de la profundidad de la obstrucción, la miliaria puede ser cristalina, que es la más superficial, rubra que es la intermedia, y profunda. Las lesiones varían de vésiculas transparentes a papulovesículas o a pápulas edematosas. No se acompaña casi de síntomas y evoluciona favorablemente; desaparece en pocos días cuando cesa, el estímulo causal (AU)

Miliaria rubra of the lower limbs in underground miners.

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.

Summer and skin.

Some skin problems either occur exclusively in summer, or are exacerbated by heat and humidity. The more common of these conditions are discussed briefly in this article.

Congenital miliaria crystallina.

Miliaria crystallina is characterized by intracorneal or subcorneal, 1 to 2 mm, clear, noninflammatory vesicles that typically appear in crops after a severe sunburn or during a febrile illness. They frequently occur in neonates, most likely due to lack of maturation of the sweat duct during the first few days following birth, but are rarely present at delivery. We describe here a patient with extensive miliaria crystallina that was present at birth and review possible theories of the pathogenesis of these lesions.

Common dermatologic disorders.

This article gives a brief synopsis of the most common dermatologic disorders likely to be encountered by a plastic surgeon. Clinical features and aids to diagnosis are emphasized, along with treatment suggestions and characteristic photographs.

Tratamento da miliária com formula oficinal / Treatment of miliari with oficinal formula

Trata-se 20 casos de miliária. Obteve-se ótimos resultados e tolerância nos 16 casos tratados com fórmula oficinal, enquanto que nos pacientes submetidos ao tratamento com pasta d'água, os resultados foram entre regulares e maus