Sam Shuster
DOI: 10.2340/0001555577001003

From argument and a few personal observations, the hypothesis has crystallised that the miliaria commonly occurring in unacclimatised Caucasians visiting hot climates is caused by exposure to ultraviolet irradiation, by an effect on the cells of the upper epidermis, which eventually allows a split to develop between them and the new stratum corneum that grows up beneath, into which sweat from the disrupted ducts can collect as microcysts. This dehiscence is the probable explanation of sunburn peeling and photo-onycholysis. It is concluded that duct disruption, not blockage or dysfunction, is the immediate cause of the miliarias.