What is the role of lab studies in the diagnosis of miliaria?

Updated: Mar 27, 2020
  • Author: Nikki A Levin, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Miliaria is clinically distinctive; therefore, few laboratory tests are necessary.

When miliaria rubra occurs in people with darker skin types, dermoscopy showing large white globules with surrounding darker halos, appearing like a “white bull's eye,” may be helpful in making the diagnosis. [29]

In miliaria crystallina, cytologic examination of the vesicular contents fails to reveal inflammatory cells or multinucleated giant cells (as would be expected in herpes vesicles).

In miliaria pustulosa, cytologic examination of the pustular contents reveals inflammatory cells. Unlike erythema toxicum neonatorum, eosinophils are not prominent. Gram staining may reveal gram-positive cocci (eg, staphylococci).

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