Widespread Miliaria Crystallina in a Newborn with Hypernatremic Dehydration

Abstract

Miliaria, which is extravasation of sweat into the epidermis and dermis due to sweat duct obstruction, is a commonly seen dermatologic disorder in newborns. We present a case of extensive, widespread miliaria crystallina that developed in a newborn during treatment of severe hypernatremic dehydration. A possible mechanism could be the destruction of sweat ducts with excretion of sweat with high levels of sodium.

Hipernatremi ve milarya kristalina: nadir bir ilişki

“…In conclusion, we agree with Engür and coworkers [5] that high levels of sodium in sweat due to hypernatremic dehydration may induced eccrine ductal damage. We consider that this condition is rarely occurred and that MC, transient and self-limited, may developed in newborns with severe hypernatremia.…”

“…In 2012, Engür et al [5] was the first time reported that high levels of sodium in sweat in hypernatremic dehydration might be have caused eccrine duct damage, predisposing to MC. Afterward, Chao CT reported that findings of MC were observed in a male adult patient with hypernatremia, and that the vesicles were resolved spontaneously days later, along with resolution of the hypernatremia [3].…”

“…Miliaria crystallina (MC) is a superficial form of miliaria when sweat glands are obstructed within the stratum corneum [1]. Although there are few adult cases of MC associated with hypernatremia, there is only one neonatal case of MC associated with hypernatremic dehydration (HD) in the literature [3][4][5]. Herein, we report a second neonatal case with MC developed during treatment of severe HD.…”

Miliaria crystallina induced by idarubicin and all‐trans‐retinoic acid: Two case reports

“…Various predisposing factors can trigger miliaria such as febrile episodes, heat and high levels of humidity that promote profuse sweating, as well as conditions that increase sweat osmolarity of (e.g. hypernatremia) 2,5‐7 . There are also previous case reports linking miliaria with certain drugs (isotretinoin, bethanechol, salbutamol, erythropoietin, clonidine, neostigmine, chemotherapy agents) 2‐4,8 .…”

Clear vesicular eruption in the intensive care unit

“…Hypernatremia – Incorrect. A 40-year-old man and a 16-day-old nonswaddled infant, both with hypernatremia, had MC 3, 4. Excess sodium secretion through sweat in hypernatremic states likely damages eccrine ducts, allowing sweat accumulation and microcyst formation 4, 5…”