News  |  Journals  |  Conferences  |  Blogs  |  Articles  |  Forums  |  Twitter   
 

 Headlines:

 
 

Doctors Lounge - Dermatology Answers

"The information provided on www.doctorslounge.com is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician."

Back to Dermatology Answers List

Forum Name: Dermatology Topics

Question: Anhidrosis / miliaria rubra (?)


 zeromatt - Sat May 19, 2007 4:46 am

First and foremost, I want to apologize about the length of this post. I tried to keep it as brief as possible, but also want to be able to fully detail everything. Thank you.

Basically, I believe I have an inability to sweat (anhidrosis?) and from what I've been reading online, sounds like it could be miliaria rubra?

Here are excerpts from a website:
Skin Disorders

Miliaria rubra occurs when intense heat load causes prolonged and profuse sweating. It is the most common type of miliaria, in which sweat accumulates in the epidermis. Red papules, vesicles or pustules are formed, accompanied by burning and itching sensations (prickly heat). The sweat duct is plugged at the terminal portion. The production of the plug is attributable to the action of resident aerobic bacteria, notably cocci, which increase in population greatly in the horny layer when it is hydrated with sweat. They secrete a toxin which injures the horny epithelial cells of the sweat duct and provokes an inflammatory reaction, precipitating a cast within the lumen of the sweat duct. Infiltration by leukocytes creates an impaction which completely obstructs the passage of sweat for several weeks.

Treatment. The initial and essential treatment of miliaria and sweat retention syndrome is to transfer the affected person to a cool environment. Cool showers and gentle drying of the skin and the application of calamine lotion may attenuate the patient's distress. Application of chemical bacteriostats is effective in preventing the expansion of microflora, and is preferable to the use of antibiotics, which may lead these micro-organisms to acquire resistance.

The impactions in the sweat duct slough off after about 3 weeks as a result of epidermal renewal.


Basically, it started last summer, when if I went out during the day when it was hot and walked around, I'd get this incredible itch around my ankles/feet. It progressed to be a more painful itch, and spread all over my body.

The itch got worse and worse, and by winter, I was hiving up whenever it occurred. I noticed I haven't sweat at all, and anytime I do anything close to exercise or get alerted (fight or flight situation of even the mildest forms), I'd get the itch everywhere. The hives are as described. Small red papules everywhere, mostly on my arms and chest (possibly back too). The itch was still everywhere, but it seemed only these locations would have the papules.

It progressed to be any form of activity requiring even the tiniest amount of work. I'm 20 years old.

Also, whenever I go into a hot room, or any place warmer than the previous environment I was in (for example winter, when I went from outdoors to inside), I'd start itching.

The only thing that would make it feel a little better would be if I splashed cold water all over myself, or if that's not enough, to take a cold shower.

I've been to the hospital many times about it, but the doctors don't have a clue and sent me to the allergist. I've had many blood tests done to check thyroid, liver, and other functions, as well as some common autoimmune diseases. All were normal. I then had a prick test and showed no signs of allergies. At this point, there was nothing they could do.

I've tried antihistamines of the strongest forms to no avail. Next I was able to get to a dermatologist, but they don't know either and sent me back to the allergist for the same prick test again, which obviously didn't help.

I've tried changing diets to no help. I've pretty much become nocturnal since it's cooler at night, but since my sleep patterns are constantly shifting hours ahead or behind, I'm always tired. Summer is coming, and it's become more unbearable than ever.

The dermatologist didn't really think it could be miliaria for some reason, although it seems to be it to me, at least rubra. The website I linked says something about a bacteriostat, but I'm not sure how to have the doctor further investigate into that and possibly prescribe it, since they don't know what it is and aren't looking into miliaria rubra.

I am truly in need of help and pretty much begging for it here. It's destroyed my life pretty much. I'm hoping that if you guys might not know of it much if you knew of doctors you could possibly not mind asking on my behalf. I would truly appreciate it.

I'm unable to do any work, including get any real form of job since I'd be constantly in extreme pain and soaking myself with cold water, which of course is a big nono in the workworld, and am falling into debt and almost pretty much out of credit to continue on.

Please, I really don't mean to sound like this, but I am pleading for help.

I just noticed the "your topic should include" so here it goes:
1. 20
2. Male
3. None that are specific except for "urticaria" based on the symptoms I've described and the doctors have witnessed.
4. None
5. None relevant
6. None currently. Tried visterol, claritin, benedryl, doxepin, singulaire, allegra, and other forms of antihistamines

I really hope the information I've provided can be of some help, and again I apologize about the length of this post. I really wanted to be as specific as possible.

If there's anything else that would help, please do tell and I'll try to elaborate further.

Again, thank you greatly for taking the time to read this, and I hope you guys can help. It seems no one else can, and I'm almost out of life.
 zeromatt - Sat May 19, 2007 4:52 am

Sorry, I didn't see an edit button but wanted to further ask some questions. Could this be a fungal infection? If so, I'm not quite sure how to treat it myself since it's not localized. I'm quite tempted to get some yeast infection creme just to apply it to some areas and see if anything happens. Or if it is indeed a coccus infection above the dermis like mentioned in the miliaria rubra web site, how could I go about it. It says that that area is more resistant to antibiotics and I've been on penicillin for a strep throat infection recently, as well as tried a few of my friend's antibiotics (doctor).

Again, thank you greatly.
 zeromatt - Thu May 24, 2007 7:36 am

Hi again. I'm sorry to be bumping this thread. I know it's against rule 3, but something came up and I need to be out and about all day tomorrow (supposed to be 90'f outside. I usually stay indoors with the AC on if it's above 70'f outside...) and need to be completely professional all day. I was wondering if there's anything I can ask a doctor to give me for one day to allow me to function fine. I could wear an undershirt and have it completely soaked to prevent overheating, but I cannot be itching at all. So far, the doctors only want to give me a benedryl shot, but I'm pretty sure that wouldn't work at all, and the doctor said I'd need to be picked up from the hospital because I wouldn't be allowed to drive, and that I'd be asleep the entire day as a result, which would be completely useless.

Any ideas? Any at all?
 dnflgmn - Thu May 24, 2007 2:04 pm

First of all, I'm not a doctor at all, just a fellow sufferer, so you should probably take what I say with a grain of salt. I have urticaria/cold-related hives and claritin helps them. I went to Puerto Rico a few months ago and after using Neutrogena sensitive skin sunscreen I got what apparently was miliaria- a continuous red, itchy, at times prickly, bubbly rash that started at the sites of heaviest sunscreen usage and spread rapidly (even after having stopped using the sunscreen) and completely covered my body from the shoulders down within a few days. I called up my dermatologist from home and explained the problem to him and he prescribed me Betamethasone Dipropionate Ointment (.05%) once a day in the mornings and Betamethasone Dipropionate Cream (.05%) once a day at night. He also told me not to take benadryl and prescribed me some other oral medication to help stop the itching and told me to stop taking doxycycline which I was taking. The rash went away in about a week or two using the medication (I also returned to the States/a cooler climate in that time). This doesn't sound like the same case as yours but similar, so maybe it will help (and it sounds like at this point you're willing to try anything). Also, I'm 19 and female if that helps. Good luck!
 zeromatt - Fri May 25, 2007 5:04 am

dnflgmn wrote:First of all, I'm not a doctor at all, just a fellow sufferer, so you should probably take what I say with a grain of salt. I have urticaria/cold-related hives and claritin helps them. I went to Puerto Rico a few months ago and after using Neutrogena sensitive skin sunscreen I got what apparently was miliaria- a continuous red, itchy, at times prickly, bubbly rash that started at the sites of heaviest sunscreen usage and spread rapidly (even after having stopped using the sunscreen) and completely covered my body from the shoulders down within a few days. I called up my dermatologist from home and explained the problem to him and he prescribed me Betamethasone Dipropionate Ointment (.05%) once a day in the mornings and Betamethasone Dipropionate Cream (.05%) once a day at night. He also told me not to take benadryl and prescribed me some other oral medication to help stop the itching and told me to stop taking doxycycline which I was taking. The rash went away in about a week or two using the medication (I also returned to the States/a cooler climate in that time). This doesn't sound like the same case as yours but similar, so maybe it will help (and it sounds like at this point you're willing to try anything). Also, I'm 19 and female if that helps. Good luck!
Thanks for the reply. I think my friend might have a similar situation with allergies to cold. Was your urticaria combined with a burning pain? I imagine you still had ability to sweat through the process?

Thanks for the reply. It's good to hear people are reading this. I've been off the strong antihistamine since it only seemed to work once or twice (although I'm not sure if it's completely related). I'm planning on taking it again today and hoping it does at least a little. On top of that, I'm going to be wearing a soaked tshirt underneath and hoping it won't aggravate matters more.

Looks like the day is about to start. Guess I'm hoping for the best, or at the very least, a lesser worse.
 itchytom - Thu Jun 10, 2010 8:55 pm

Hi zeromatt, I know this is an old thread but on the off chance you still check it or are notified of my post I would really appreciate your help. I'm a 22 year old male who lives in a reasonably cold climate (bottom of New Zealand) and I seem to have the exact same problem as you. At first the doctors all said "prickly heat" and prescribed me antihistimines but I've gotten intolerably itchy at least once a day for the last two years. It has completely changed my life, I can't walk at normal pace in sunlight for more than two minutes or even wash the dishes without getting the red itchy rash all over my body. I've been to three doctors to no avail. Every where I've looked on the internet assumes it only happens on holiday or in a "hotter climate" but I get itchy wherever/whenever there is a slight increase in temperature (regardless of the absolute temperature) or activity. Please if there is anything you've learnt that could help me get control back over my life I would be very appreciative.

Thanks
 Dr.M.jagesh kamath - Sun Jun 13, 2010 9:41 pm

User avatar Hello,Cholinergic urticaria is a condition in which increase in core body temperature makes one itch and associated with sweating.Sometimes this occurs if one is not acclamatised to the increased temperature.Excercise could precipitate this.
Solar urticaria is much rarer when one breaks hives on exposure to sunlight.
Of course there are other causes like a photodermatitis which generally occurs on the exposed parts of the body.
Phototesting,evaluation of porphrin levels are a few tests for evaluation.
Antihistaminics are the mainstay in treatment.
Best wishes.

|

Check a doctor's response to similar questions

 

advertisement.gif (61x7 -- 0 bytes)
 

Are you a Doctor, Pharmacist, PA or a Nurse?

Join the Doctors Lounge online medical community

  • Editorial activities: Publish, peer review, edit online articles.

  • Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.

Doctors Lounge Membership Application

 
     

 advertisement.gif (61x7 -- 0 bytes)

 

 

Tools & Services: Follow DoctorsLounge on Twitter Follow us on Twitter | RSS News | Newsletter | Contact us

 
Copyright © 2001-2010
Doctors Lounge.
All rights reserved.

Medical Reference:
Diseases | Symptoms
Drugs | Labs | Procedures
Software | Tutorials

Advertising
Links | Humor
Forum Archive
CME Articles

Privacy Statement
Terms & Conditions
Editorial Board
About us | Email

We subscribe to the HONcode principles of the HON Foundation. Click to verify.We subscribe to the HONcode principles.
Verify here