Hair
Pseudomonas Folliculitis
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Pseudomonas Folliculitis
, Hot Tub Folliculitis
See Also
Deep Folliculitis
Etiology
Pseudomonas
aeruginosa contaminated water
Whirpool or hot tub
Contaminated loofah sponge
Contaminated diving suit
Waterslide or small pool
Symptoms
Onset 8 hours to 5 days (mean 2 days) after exposure
Pruritic rash most severe in bathing suit area
May be associated with systemic symptoms
Malaise
Fatigue
Low grade fever
Signs
Characteristics: Perifollicular lesions
Initial
Urticaria
l
Plaque
under 3 cm
Central
Pustule
or
Papule
Healing
Red-brown hyperpigmented lesions
Distribution
Most severe in areas under snug bathing suit
Trunk and extremities affected
Head usually not involved
Course
Resolves within 7-10 days
May recur within first 3 months
Management
Self-limited infection resolves spontaneously
Symptomatic therapy
Acetic acid 5% compresses for 20 minutes bid-qid
Silver Sulfadiazine
(Silvadene) applied bid-qid
Refractory or persistant cases
Ciprofloxacin
500 mg bid for 5-7 days
Prevention
Employ continuous
Water Filtration
Change hot tub or whirlpool water frequently
Drain private hot tubs q1-2 months
Drain public hot tubs daily
Clean hot tub when drained with acidic cleaner
Ensure adequate disinfection
Keep
Chlorine
levels (1-3 mg/liter or >1 ppm)
Maintain water pH 7.2 to 7.8
Consider using bromine instead of
Chlorine
References
Fitzpatrick (1992) Color Atlas Dermatology
Habif (1996) Dermatology, p. 258-259
Rhody (2000) Prim Care 27(2):459-73 [PubMed]
Stulberg (2002) Am Fam Physician 66(1):119-24 [PubMed]
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