What is Pseudomonas folliculitis (hot tub folliculitis)?

Updated: Oct 02, 2020
  • Author: Charles B Toner, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Pseudomonas folliculitis is a community-acquired skin infection, which results from the bacterial colonization of hair follicles after exposure to contained, contaminated water (eg, whirlpools, [1, 2, 3, 4, 5, 6] swimming pools, [7] water slides, bathtubs). Pseudomonas is one of the top three pathogens associated with recreational water use. [8] First reported in 1975 in association with whirlpool contamination, Pseudomonas folliculitis is caused by strains of Pseudomonas aeruginosa that are acquired secondary to skin contamination.

The rash of Pseudomonas folliculitis has also been described following the use of diving suits in both seawater and fresh water immersion, [9, 10] and, less commonly, following the use of contaminated bathing objects (eg, synthetic and natural sponges) or inflatable swim toys. [11, 12, 13, 14] Pseudomonas folliculitis has occurred after skin depilation and with no obvious recreational exposure.

Pseudomonas folliculitis also rarely occurs as a perioral acneiform eruption in patients on long-term antibiotic (eg, tetracycline) therapy for acne. [15]


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