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Accessory Structures of the Skin: Hair and Hair Follicles01:16

Accessory Structures of the Skin: Hair and Hair Follicles

Hair and hair follicles are integral components of the integumentary system. Hair is a filamentous structure composed mainly of a protein called keratin. It is found on the surface of the skin throughout the body, except for areas such as the palms of the hands and soles of the feet.
Hair is a keratinous filament growing out of the epidermis. It is primarily made of dead, keratinized cells. Hair strands originate at the epidermal penetration called the hair follicle. The hair shaft is the part...
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Accessory Structures of the Skin: Sebaceous Glands

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Dermis
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Pruritus, papules, and perspiration.

Mark S La Shell1, Michael S Tankersley, Abel Guerra

  • 1Department of Pediatrics, 60th Medical Group, Travis AFB, California 94535-1800, USA. mark.lashell@travis.af.mil

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|March 24, 2007
PubMed
Summary

Miliaria crystallina, characterized by itchy bumps with increased body temperature, can mimic cholinergic urticaria. An exercise challenge aided diagnosis in an 18-year-old woman whose symptoms resolved spontaneously.

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Area of Science:

  • Dermatology
  • Allergy and Immunology

Background:

  • Pruritic papules and increased body temperature are common in allergy practice, often misdiagnosed as cholinergic urticaria.
  • Cholinergic urticaria is frequently suspected in patients presenting with exercise-induced pruritus and papular eruptions.

Observation:

  • An 18-year-old woman presented with a 6-month history of facial burning, pruritus, and pinpoint bumps during exercise and hot tub use.
  • Symptoms included diffuse pruritus and pinpoint vesicles on the abdomen and extremities, exacerbated by exercise.

Findings:

  • An exercise challenge revealed facial flushing and numerous pinpoint translucent vesicles, leading to a diagnosis of miliaria crystallina.
  • The patient experienced no relief with cetirizine for exercise-induced miliaria, but symptoms resolved spontaneously within a year.

Implications:

  • This case highlights the importance of considering miliaria in the differential diagnosis of pruritic papular eruptions associated with increased body temperature.
  • Exercise challenge is a valuable diagnostic tool for intermittent, perspiration-induced skin conditions that may mimic cholinergic urticaria.