Folliculitis is characterized by the formation of erythematous papules or pustules around hair follicles. Lesions tend to arise quickly and are often pruritic or painful. Most cases are due to bacterial infection with Staphylococcus aureus or gram-negative bacteria. The history and location of lesions can often help determine the likely inciting cause.
This patient who swam in a resort pool likely developed hot tub folliculitis due to Pseudomonas aeruginosa infection. This form of folliculitis develops in the distribution of a wet bathing suit (eg, buttocks, upper thighs) 8-48 hours after swimming in contaminated water. Antimicrobial treatment is typically unnecessary as most patients recover spontaneously within 7-10 days. However, patients should be advised to practice good skin hygiene and avoid continued exposure to contaminated water.