Persistence of impaired heat tolerance from artificially induced miliaria rubra.

Ten volunteers were heat acclimatized to 48.9 degrees C (Ta), 20% rh for 7 days to complete a 100-min walk on a level treadmill (1.56 m x s-1). Subjects were then divided into experimental (n = 6) and control (n = 4) groups. Miliaria rubra (heat rash) was then induced on the experimental subjects by wrapping them for 3 days in polyethylene plastic. All six developed marked miliaria with involvement of 40-70% of the total body surface area. All subjects were reexposed to walking in the heat on the 7th day after unwrapping, by which time rash was clinically indetectable, and again 14 days after unwrapping. On the first test (day 7) only one of the rashed group, and on the second test (day 14) only two could complete the 100-min walk; the control group finished without difficulty on both days. Body heat storage for the rash group was 2.5 times that of the control group on day 7 and 1.5 as great on day 14; measurements of mean body temperature (Tb) on the rash group indicated a much greater heat stress when compared to their own prerash-acclimatized values or those of the control group. These data demonstrate the potential of "healed" miliaria in the etiology of clinical heat illness.

Heat intolerance as a function of percent of body surface involved with miliaria rubra.

Twenty-four heat-acclimatized male volunteers were wrapped as previously described (Am. J. Physiol. 239 (Regulatory Integrative Comp. Physiol. 8): R226-R232, 1980) but to produce miliaria rubra (heat rash) in specific regions of the body. Three experimental rash groups were involved: 1) the torso (17% total skin surface rashed, n = 6), 2) torso and arms (38%, n = 8), or 3) legs (41%, n = 6), while four subjects served as controls. All subjects were reexposed to walking in the heat on the 7th day after unwrapping, and again 14, 21, and 28 days after unwrapping. When compared to responses for the last heat acclimatization day, tolerance time and sweat rate were lower and mean body temperature and delta heat storage significantly higher for experimental rash subjects contrasted to the controls for up to 21 days; however, no significant differences between the three rashed groups were found. The critical amount of surface area for heat intolerance from heat rash appears to be related to the specific region of the body and associated sweating responses; smaller rashed areas of the trunk, because they have greater potential for abundant sweating, may produce similar responses to heat stress as larger rashed areas of the limbs. Heat intolerance due to rash was not resolved until after 21 days.