Patient Case: Miliaria (Prickly Heat)
A 28-year-old woman presents to the clinic with an itchy, red rash on her neck, upper chest, and back that developed over the past three days. She recently returned from a beach vacation in a tropical climate, where she spent long hours outdoors in hot, humid conditions. She reports a prickling or stinging sensation in the affected areas, which worsens when she sweats.
On examination, there are multiple small, erythematous papules and vesicles concentrated in areas where clothing rubs against the skin. No signs of infection or systemic symptoms are noted.
Based on her history and clinical findings, she is diagnosed with miliaria rubra (prickly heat), a heat-induced sweat gland obstruction. She is advised to stay in a cool, well-ventilated environment, wear loose, breathable clothing, and use calamine lotion for symptomatic relief. Her rash resolves within a few days after avoiding excessive heat and sweating.
- What is the most likely cause of this patient’s rash?
a) Contact dermatitis
b) Miliaria rubra (prickly heat)
c) Folliculitis
d) Atopic dermatitis - What is the primary underlying mechanism of miliaria rubra?
a) Bacterial infection of the sweat glands
b) Inflammatory reaction to heat exposure
c) Blockage of sweat ducts leading to sweat retention and skin irritation
d) Allergic reaction to excessive sun exposure - Which of the following is the most effective initial treatment for miliaria?
a) Oral antibiotics
b) Keeping the skin cool and dry
c) Systemic corticosteroids
d) Antifungal cream - Which factor most likely contributed to the development of this patient’s miliaria?
a) Recent sunburn
b) Excessive sweating in a hot, humid environment
c) Exposure to an allergen
d) Use of a new sunscreen
