Internal Medicine

0521779407-14 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:16

986 Miliaria Mineralocorticoid Disorders

■Hydrophilic ointment helps to dissolve keratin plugs.

■Lotion with 1% menthol and glycerin and 4% Sal Ac in 95% alcohol

dabbed on until desquamation starts

follow-up

n/a

complications and prognosis

■Usually self-limited with cooling and treatment

■Postmiliarial hypohidrosis may result in sweating decreased up to

half of normal for as long as 3 weeks.

MINERALOCORTICOID DISORDERS

RICHARD I. DORIN, MD

history & physical

History

■Salt, potassium intake

■Review of prior BP determinations, electrolyte studies

■Vomiting, diarrhea

■Renal insufficiency

■Edema, cirrhosis, CHF, nephrotic syndrome

■Nocturia, polyuria, muscle weakness, cramps

■Purging, anorexia, surreptitious diuretic or laxative use or abuse

■Cushing’s syndrome, adrenal insufficiency

■Diabetes mellitus

■Medications: diuretics, antibiotics, glucocorticoids, heparin, ACE

inhibitors, spironolactone, amiloride, triamterene

■Family history of hypertension/hypokalemia

■Malignancy: history of malignancy, cigarette smoking, weight loss,

bone pain, abdominal pain, flushing

Signs & Symptoms

■Mineralocorticoid excess: polyuria, nocturia, hypertension, edema

(rarely)

■Mineralocorticoid deficiency: generally nonspecific, rarely hypoten-

sion or orthostatic hypotension

tests

Laboratory

■Basic blood studies: