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Fig. 27.11 Pseudomonas folliculitis. Patient with history of recent hot tub exposure and development of numerous truncal follicular-based papules and pustules. (Courtesy of the Fitzsimons Army Medical Center teaching files.) |
Clinically, it occurs 1 to 3 days after exposure, presenting as a diffuse truncal eruption (Fig. 27-11). The primary lesion is a follicular-based erythematous papule that frequently demonstrates a follicular pustule. Less commonly, patients may also demonstrate mastitis, abscesses, lymphangitis, and fever. Another variation is those patients that present with painful indurated lesions of the feet and/or hand that may become pustular (“
Pseudomonas hot hand-foot syndrome”). The disease is usually self-limited, although rare patients may continue to develop recurrent folliculitis or abscesses for up to 2 months.