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September 1982

Hot Tub Folliculitis: A Sheep in Wolf's Clothing

Author Affiliations

3020 Beard Rd Napa, CA 94558; 1100 Trancas Napa, CA 94558

Arch Intern Med. 1982;142(9):1620. doi:10.1001/archinte.1982.00340220034006

Pseudomonas aeruginosa folliculitis, occurring in association with use of public hot bath facilities, has been familiar to epidemiologists and some dermatologists since the early 1970s. Since 1975, five reports of epidemics involving 27 to 75 clinically ill persons have been published.1-3

The importance of reexamining this disease now is that it has become apparent that the same clinical syndrome can occur as isolated cases associated with use of home hot tubs and spas.4 In such nonepidemic circumstances, when the patient does not relate his illness to hot tub use, this self-limited and benign disease may be mistaken for more serious problems, eg, meningococcal or gonococcal septicemia, atypical virus, severe contact dermatitis, or other serious infection with rash.

The illness is similar, whether contracted in public facilities or in a home hot tub, and usually begins six hours to five days after the episode of hot tub use; a