A recent study published in the British Journal of Haematology has found that a jacuzzi may trigger the relapse of immune thrombocytopenia purpura (ITP). The researchers emphasized that people should be aware of the potential dangers of jacuzzis.

Immune thrombocytopenia purpura, commonly known as immune thrombocytopenia, is an autoimmune disease characterized by low platelet count in the body, often below 100,000/µL. The disease has an annual incidence of 1 to 6.4 cases per 100,000 in children and 6 cases per 100,000 in adults. The major symptoms associated with ITP include easy bruising, bleeding from the nose or gums, blood in urine or stools, and heavy menstrual flow.

Read more about  ITP therapies

A number of treatment therapies are employed for ITP, including corticosteroid administration as the first-line treatment. Other treatment options include splenectomy, thrombopoietin receptor agonists, fostamatinib, Rituxan® (rituximab), and immunomodulatory agents.

The present study investigates the impact of hot water baths on ITP relapse. The researchers presented a case of a 21-year-old male who came to the hospital with bull-eye skin lesions on his back. He had a history of ITP episodes, which were treated with short steroids courses instead of chronic treatment. The patient had not recently traveled, was not taking any medication, and had not received a cupping massage. Further examination revealed isolated thrombocytopenia with a low platelet count and no clotting abnormalities in his blood.

Additional inquiry revealed that the patient had attended a party and had a jacuzzi session. Upon closer investigation, it was found that the pattern of the skin lesions matched the pattern of the jacuzzi water jet. Following that, he was treated with dexamethasone corticosteroid for 4 days which improved his condition and resulted in an increase in his platelet count and regression of the skin lesions.

Through this study, the researchers emphasized the importance of educating people about the potential dangers of Jacuzzis that could worsen their condition. Moreover, physicians should consider all possible factors when treating patients with autoimmune disorders such as ITP.

We should have warned our patients about the potential danger of Jacuzzis,” the authors highlighted.


Debureaux, PE,  Harel, S. Immune thrombocytopenia purpura relapse presented by Jacuzzi sign. Br J Haematol. Published online Jun 6, 2023. doi:10.1111/bjh.18865