Bilateral symmetric ankles and feet cellulitis after fish pedicure: Case report and review of the literature

Fish pedicure (feet immersion in a tank containing fish Garra rufa or Cyprinion macrostomus) is a widely diffuse cosmetic practice, usually considered safe. However, this practice is regulated only in a few Countries, and the risk of infection related to this practice is not quantified. We report a case of bilateral symmetric ankles and feet cellulitis in a previously healthy young woman without risk factors for infections, after a fish pedicure in Greece. Three cases of foot infection after fish pedicure have been described in the English literature, two sustained by S. aureus and one by Mycobacterium marinum, but none of them was so extensive, involving not only feet but also ankles. The practice of the aesthetic fish pedicure should be regulated in all Countries to reduce the risk of complications related to this procedure. Moreover, studies targeted at investigating the risk of infection associated with this procedure are warranted. Keywords: Fish pedicure; Cosmetic procedure; Cellulitis; Risk infection.

Fish Pedicure: A Risky Aesthetic Treatment for Tourists

Fish pedicure is considered to be an aesthetic treatment, first conceived in Turkey, in Kangal Hot Springs. These hot waters are rich in two species of fish of the Cyprinidae family that feed on the stratum corneum layer of patients with psoriasis. This treatment was later adapted to many spa resorts for “fish pedicure.” In this article, we performed a review of the skin infections already reported, explaining why this procedure, performed usually during summer holidays by tourists, is not risk free and should be discouraged by health workers.