Abstract

Introduction. Miliaria is a skin disorder due to blockage/interruption of the eccrine sweat glands that often caused by increased heat, humidity and resident skin organism. In hospital, miliaria is frequently found in patients with prolonged hospital stay. Types of miliaria are miliaria crystallina, miliaria rubra and miliaria profunda. Miliaria pustulosa is a variant of miliaria rubra in which vesicles develop into pustules. Case. Female, 16 year olds consulted from Neurosurgeon Department H. Adam Malik General Hospital with reddish papules and pustules accompanied with pain and itchy at back and chest since 12 days hospitalized. Firstly rose in back region then spread to chest, neck and became pustules. Dermatology status showed in interscapularis, thoracalis and colli region, miliar pustules and erythematous papules were found. Differential diagnoses were miliaria pustulosa, steroid acne and drug allergic eruption with miliaria pustulosa as working diagnosis. Lotio faberi combined with gentamycin sulfate cream 0.1% and cetirizine 10 mg tablet once daily were given as treatments. Patient advised to wear lightweight clothing and avoid exposure to conditions of high heat and humidity. After 7 days of treatment, patient showed good clinical improvement. Discussions. In several cases of miliaria, Staphylococcus aureus and Staphylococcus epidermidis are thought to play a role in pathogenesis of miliaria which turn vesicles into pustules. In this case, patient underwent craniotomy that cause prolonged hospital stay. Treatment was selected based on involved extensive area, simple administration, contained ingredient that reduced humidity, cure inflammation/infection and minimized itchy to comfort patient.

Keywords. Miliaria pustulosa, eccrine sweat gland, post craniotomy