Hot tub dermatitis: a familial outbreak of Pseudomonas folliculitis

Pseudomonas folliculitis resulting from the use of spa pools, whirlpools, and hot tubs is a newly described disease that typically develops 8 to 48 hours after exposure in a contaminated facility. The eruption consists of pruritic papules, papulopustules, nodules, and urticarial lesions on the trunk and extremities. A family of three and a neighbor developed Pseudomonas folliculitis after using a home hot tub from which P. aeruginosa was cultured. Skin biopsies showed an acute, suppurative folliculitis and dermal abscess formation. Although the eruption usually resolves spontaneously within 7 to 10 days, proper maintenance of equipment and adequate disinfectant levels are necessary to prevent its recurrence.