In a recent paper, Dobson and Lobitz1 posed certain questions regarding the fundamental predisposing and exciting causes of miliaria. This essay attempts to answer some of these problems by means of clinical and histopathologic observations and by experimental reproduction of the same features.
The hypothesis here submitted is that miliaria may be caused by the presence of sodium chloride on the skin in more than isotonic concentration.
Miliaria will be used to designate miliaria rubra (prickly heat).
Crystallina will be used as an abbreviation for miliaria crystallina (sudamina).
Epidermal sweat duct (E.S.D.) comprises that portion of the eccrine sweat duct which lies in the epidermis.
Ostium, pore, poral refers to the terminal portion of the E.S.D.
The excellent monograph of Sulzberger and Herrmann2 gives a concise review of this subject up to the year 1954. It also provides a quotation which furnishes a convenient introduction to this
LOEWENTHAL LJA. The Pathogenesis of Miliaria: The Role of Sodium Chloride. Arch Dermatol. 1961;84(1):2–17. doi:10.1001/archderm.1961.01580130008002
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