Miliaria (Sweat rash)

Japanese: 汗疹（あせも） - かんしん（あせも）（英語表記）Miliaria (Sweat rash)

What is the disease?

It appears after excessive sweating. It is common in the summer and is prone to develop in children. It can also develop in patients with febrile illnesses or those who work in high-temperature environments.

What is the cause?

After sweating profusely, Sweat ducts ( Enthusiastic ) It occurs when the sweat ducts become blocked. Crystal ( Water supply ) heat rash, Red ( Food ) heat rash, Deep ( New life ) There are three types of miliaria. In miliaria quartz, the sweat ducts are blocked by the stratum corneum on the surface of the skin. In miliaria rubra, Epidermis spinosum ( Hyohyo Yukyokuso ) In miliaria profunda, the sweat ducts become blocked within the dermis.

How symptoms manifest

In miliaria quartz, small spots are present, about 1 to 3 mm in diameter. Blisters ( Water ) (Figure 106) There are no subjective symptoms such as itching or pain. Papule ( Emergency ) These occur frequently and may be accompanied by mild itching or a slight tingling pain.

In miliaria profunda, skin-colored flat, raised papules Pavement ( Stationary ) It is common in people who are repeatedly exposed to high temperatures, such as those who work long hours in tropical regions or in hot environments. Sweating is no longer possible in areas with rashes of miliaria profunda. If miliaria is widespread, the body's ability to regulate its temperature is reduced, so it is important to be careful of heatstroke.

When a bacterial infection occurs in conjunction with sweat rash Pustular ( News ) It becomes miliaria. It can be pustular miliaria, contagious impetigo (impetigo) or sweat gland rash. abscess ( Use ) It can also be.

Testing and diagnosis

It is possible to make a diagnosis just by listening to the patient's medical history and looking at the rash. If bacterial infection is also involved, bacterial cultures will be performed and antibiotic sensitivity tests will be performed. If it is difficult to distinguish from other diseases, a biopsy (tissue sampling) will be performed on the affected skin and a histopathological examination will be performed.

Treatment methods

Crystalline miliaria will heal naturally without any special treatment. For miliaria rubra, apply a steroid cream. For miliaria profunda, avoid high temperatures, live in a cool environment, and wait for it to heal naturally.

In the case of pustular miliaria, which is accompanied by bacterial infection, antibiotics are administered systemically. Drainage of pus ( Yes. ) You need to.

What to do if you notice an illness

When a child develops the disease, you can prevent it from developing by making sure the room temperature is not too high and that the child is not dressed too thickly. Even when a child has a cold, avoid dressing them too thickly.

Miliaria crystalloid and mild miliaria rubra will heal naturally. If there is severe itching, redness, or swelling, you should see a dermatologist as this may be due to bacterial infection.

Kenji Saga

Figure 106 Crystalline miliaria
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Figure 106 Crystalline miliaria

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　汗を多量にかいたあとに現れます。夏期に多く、小児に発症しやすい疾患です。発熱性疾患の患者さんや高温の環境で作業に従事している人が発症することもあります。

原因は何か

　多量に汗をかいたあとに、汗管(かんかん)（汗の出る管）が詰まって発症します。水晶様(すいしょうよう)汗疹、紅色(こうしょく)汗疹、深在性(しんざいせい)汗疹の3つの型があります。水晶様汗疹では皮膚表面の角層で汗管がふさがります。紅色汗疹では表皮有棘層(ひょうひゆうきょくそう)で汗管がふさがります。深在性汗疹では真皮内で汗管がふさがります。

症状の現れ方

　水晶様汗疹では直径1～3㎜程度の小さな水疱(すいほう)が多発します（図106）。かゆみや痛みなどの自覚症状はありません。紅色汗疹は赤い丘疹(きゅうしん)が多発し、軽いかゆみやチクチクした軽い痛みを伴っていることがあります。

　深在性汗疹では皮膚色の扁平に隆起した丘疹が敷石状(しきいしじょう)に多発します。深在性汗疹は熱帯地方や高温の環境で長時間作業に従事している人のように、繰り返し高温にさらされると現れます。深在性汗疹の発疹がある部位では汗が出なくなっています。汗疹が広範囲にあると体温調節能力が低下しているので、熱中症に注意する必要があります。

　汗疹に細菌感染が加わると膿疱性(のうほうせい)汗疹になります。膿疱性汗疹から伝染性膿痂疹(のうかしん)（とびひ）や汗腺膿瘍(のうよう)になることもあります。