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[Whirlpool-dermatitis with "hot hands"].

Authors:
K-A Dietrich T Ruzicka T Herzinger

Dtsch Med Wochenschr 2014 Jul 1;139(28-29):1459-61. Epub 2014 Jul 1.

Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München.

History And Admission Findings: A 15-year-old boy presented with painful nodules on his palms and discrete pustules on the forearm. Two days earlier he had taken a bath in a new whirlpool.

Investigations: Bacteriological examination of the pustules revealed Pseudomonas aeruginosa. The cervical and axillary lymph nodes were inconspicuous.

Treatment And Course: The dermal infection with Pseudomonas aeruginosa was treated with i.v. piperacillin 4 g/tazobactam 0,5 g twice daily. Furthermore, the patient received 400 mg ibuprofen twice daily per os. Seven days later all symptoms had resolved.

Conclusion: Hot tubs are a potential source of cutaneous infections with the gram-negative rod Pseudomonas aeruginosa. The most common clinical manifestation of these infections is "hot tub- or jacuzzi-folliculitis" with pustules mainly on the trunk and lymphadenopathy. In children and adolescents, the clinical picture may differ, with a predominance of tender reddish nodules on the palms or soles named "hot hand/hot foot syndrome". In general, the first-line antibiotic in an infection with pseudomonas aeruginosa is ciprofloxacin but it is not recommended in children and adolescents.

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http://dx.doi.org/10.1055/s-0034-1370154DOI Listing
July 2014

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