By Gary M. White, MD
Miliaria profunda (MP) is a variant of miliaria in which obstruction of the sweat gland occurs at a deep level, leading to rupture of the duct at the dermoepidermal junction.
- MP is most common in the tropics and usually occurs only after repeated episodes of miliaria rubra.
- In a recent study [JAMA Derm 2015;151;346], the evanescent skin papules were found to be intraepidermal and hyperkeratotic plugs at the sweat orifices were causing the obstruction.
Pale, 1-3 mm papules on the trunk are most typical. They may appear as "goose-bumps." There is no pain or pruritus. There may be generalized anhidrosis. It may be brought on by exercise and resolve with cooling.
Obviously, avoiding excessive sweating is recommended to prevent future flares. Comfortable clothing and soothing, cool environments may be advised. Topical steroids may also be tried.
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