Background: The term "miliaria" is used to describe a group of highly transient skin disorders in the newborn characterized by eccrine duct obstruction and the passage of sweat into the epidermis and papillary dermis. This rash in the susceptible skin of the neonate is brought on by heat and confined environments. Our paper reports several episodes of pustular miliaria rubra associated with salt loss crises in a newborn with systemic pseudohypoaldosteronism type 1b (PHA).
Observation: Since the first days of life, the child presented severe and diffuse miliaria comprising many disseminated pustules associated with salt loss syndrome. Pseudohypoaldosteronism type 1b was readily diagnosed on the basis of aldosterone, sodium and chloride levels in sweat, saliva and in feces. The course was characterized by chronicity and flares simultaneously with salt loss.
Discussion: Associated pseudohypoaldosteronism type 1b/red miliaria is not fortuitous with this in fact being the second case reported in the literature. Obstruction of the eccrine ducts and pustular exanthema were probably due to abnormal Na+ levels in sweat.