Histopathologic examination revealed multiple subcorneal vesicles with a few neutrophils and scattered eosinophils. The surrounding epidermis was spongiotic. A dermal eccrine sweat gland duct was contiguous with some of the vesicles. The dermis showed a sparse superficial and interstitial lymphohistiocytic infiltrate. The microscopic findings were consistent with miliaria crystallina.
The patient, who was critically ill, had been persistently febrile and was immobile. The dermatological consultation service advised frequent positional changes and avoidance of the use of occlusive topical agents. Desquamation of the superficial-most layers of the skin occurred on days 4 and 5. The lesions resolved within 7 days as the patient's overall status improved.
Vesicular Eruption on the Trunk and in Intertriginous Folds—Diagnosis. Arch Dermatol. 2004;140(2):231-236. doi:10.1001/archderm.140.2.231-f