11/14/2022 0 Comments Swimmers itch vs chiggersHumans are not the usual host for fleas, but they will sometimes transfer from an infected host causing clusters of bites but in a more nondescript pattern especially on the lower extremities. In contrast to this patient’s lesions being underneath her bathing suit, chigger infestations usually occur at areas where clothing stops the migration of the larva hence they often cluster at beltlines or the top of the socks. Less commonly, Pseudomonas in hot tubs can cause tender erythematous nodules of the feet and hands known as “hot hand-foot syndrome.”Ĭhiggers can also present as erythematous itching lesions, sometimes with a pustular center. The spa should be cleaned and the chemical levels adjusted appropriately. Anti-Pseudomonal antibiotics including ciprofloxacin are only used in severe cases and fluoroquinolones are usually avoided in children. Treatment is supportive for the patient as it is self-limited in most cases. It is caused by overgrowth of Pseudomonas when the antibacterial chemical levels in the water are too low. This itching papular and pustular eruption, limited mostly to the bathing suit area following the use of a whirlpool spa, is classic for Pseudomonas folliculitis also known as hot tub folliculitis. Other than itching, she has no symptoms and is in good health with no significant past medical history or medications. This 8-year-old girl came down with this itching rash following a horseback ride and a soak in a whirlpool spa.
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