Skin ConditionsSkin Conditions

Functions of SkinFunctions of SkinProtection: Protection: – UVUV– InfectionInfection– Heat RegulationHeat Regulation– InjuryInjury– Fluid/Electrolytes Loss Fluid/Electrolytes Loss

Due to tight packing of cells in upper epidermisDue to tight packing of cells in upper epidermisAlso helps avoid absorption of excessive environmental Also helps avoid absorption of excessive environmental fluids (i.e. swimming)fluids (i.e. swimming)

SensationSensationEndocrine:Endocrine:– Helps produce Vitamin DHelps produce Vitamin D

BlistersBlistersLeave blister intact as long as possibleLeave blister intact as long as possible– Protection and infectionProtection and infection

If removal is necessary, clean skin and If removal is necessary, clean skin and sharp object thoroughly sharp object thoroughly – Leave top layer of blister for protection, if Leave top layer of blister for protection, if

possiblepossible

Cover and pad with donut, if necessaryCover and pad with donut, if necessary

Keep clean and check for signs of Keep clean and check for signs of infection!infection!

Ingrown ToenailIngrown ToenailPainful conditionPainful conditionNail grows into lateral nail foldNail grows into lateral nail foldCaused by:Caused by:– Poorly fitting shoesPoorly fitting shoes– Improper nail trimmingImproper nail trimming– TraumaTrauma

Treatment:Treatment:– Soak in warm water and epson salt or betadineSoak in warm water and epson salt or betadine– Place cotton under nail to lift nailPlace cotton under nail to lift nail– Cut ‘V’ in the middle of the nail Cut ‘V’ in the middle of the nail – Surgery???Surgery???

Prevention: Prevention: – Keep nail trimmed straight across (not too long, not too Keep nail trimmed straight across (not too long, not too

short)short)

Contused NailContused Nail

Pressure and pain under nailPressure and pain under nail

May need to “drill” to relieve pressureMay need to “drill” to relieve pressure– Needle, sharp knife, or small drill bitNeedle, sharp knife, or small drill bit– Make sure surface and device are cleanedMake sure surface and device are cleaned– Go slowly so you don’t hit the nail bedGo slowly so you don’t hit the nail bed

Don’t allow athlete to rip Don’t allow athlete to rip

off nail, it may not grow back!off nail, it may not grow back!

ImpetigoImpetigoBacterial skin infection caused by strep or staphBacterial skin infection caused by strep or staphCan occur anywhere…most common around Can occur anywhere…most common around nose/mouthnose/mouthContagious & spread through close contact or Contagious & spread through close contact or sharing towels/clothing/etcsharing towels/clothing/etcTreated w/ antibiotics (oral or topical) ~3-7daysTreated w/ antibiotics (oral or topical) ~3-7daysSigns/Symptoms:Signs/Symptoms:– Red sores Red sores – Ooze fluidOoze fluid– Yellow-brown crustYellow-brown crust– Can be itchyCan be itchy

EczemaEczema

Inflammatory skin disease with red, itchy Inflammatory skin disease with red, itchy skinskin

FolliculitisFolliculitis

Infection in the hair follicle Infection in the hair follicle Most common on face/scalp & areas rubbed by Most common on face/scalp & areas rubbed by clothing, such as the thighs & groinclothing, such as the thighs & groinUsually caused by bacteriaUsually caused by bacteriaCan occur from damage caused by shaving or Can occur from damage caused by shaving or wearing clothes that rub the skin OR when wearing clothes that rub the skin OR when blocked or irritated (sweat, oil, makeup)blocked or irritated (sweat, oil, makeup)Self limiting w/ proper cleansingSelf limiting w/ proper cleansingSigns/Symptoms:Signs/Symptoms:– ““Red pimples” w/ a hair in the centerRed pimples” w/ a hair in the center– May drain pus, blood or both May drain pus, blood or both – May itch or burnMay itch or burn

Tetanus Infection (Lock Jaw)Tetanus Infection (Lock Jaw)Caused by Clostridium bacteriaCaused by Clostridium bacteriaBacteria live in soil, saliva, dust & enter body through Bacteria live in soil, saliva, dust & enter body through deep cut (i.e. stepping on nail) deep cut (i.e. stepping on nail) Causes painful tightening of the muscles, usually all Causes painful tightening of the muscles, usually all over the bodyover the body– It can lead to "locking" of the jawIt can lead to "locking" of the jaw– Impossible to open your mouth or swallowImpossible to open your mouth or swallow

Potentially life-threatening…requires immediate tx in Potentially life-threatening…requires immediate tx in hospital hospital Regular vaccines can prevent tetanusRegular vaccines can prevent tetanus– Children get shot as a part of their routine immunizationsChildren get shot as a part of their routine immunizations– Adults should get booster every 10 years and/or after a Adults should get booster every 10 years and/or after a

bad cut/burnbad cut/burn

RingwormRingwormTinea Corpus Tinea Corpus

Fungal infection of skinFungal infection of skin

Characterized by round patches w/ scaly raised Characterized by round patches w/ scaly raised boarder & central healing zoneboarder & central healing zone

Refer for correct Dx & appropriate Tx:Refer for correct Dx & appropriate Tx:– OTC: Lamisil, Lotrimin, TinactinOTC: Lamisil, Lotrimin, Tinactin

CANNOT participate in wrestling unless cleared & CANNOT participate in wrestling unless cleared & under treatment for 72hrsunder treatment for 72hrs

DO NOT just coverDO NOT just cover

Keep mats and body cleanKeep mats and body clean

Athletes FootAthletes FootTinea PedisTinea Pedis

Fungal infection of the foot Fungal infection of the foot

Sx’s: Sx’s: – Red scaly rashRed scaly rash– Peeling or cracking skinPeeling or cracking skin– BurningBurning– ItchingItching

Keep feet dry/clean!Keep feet dry/clean!

Tx: Tx: – OTC:OTC: Lamisil, Lotrimin, Tinactin Lamisil, Lotrimin, Tinactin

Jock ItchJock ItchTinea CrurisTinea Cruris

Sx’s:Sx’s: – Burning/ItchingBurning/Itching– Red, scaly patches of skinRed, scaly patches of skin

Keep area dry/cleanKeep area dry/clean

Tx:Tx:– OTC:OTC: Lamisil, Lamisil,

Lotrimin, TinactinLotrimin, Tinactin

Herpes Simplex -Herpes Simplex -(Cold Sores/Fever Blisters)(Cold Sores/Fever Blisters)

Type 1: Oral Herpes - causes sores around mouth/lips – Transmitted via oral secretions or sores on skin

Kissing or sharing toothbrushes/eating utensils

– Causes painful blisters– No cure - Remains in body & lies inactive in

nerve cells until triggered by:Sun exposure, fever, fatigue, stress

– Drugs can lessen severity

Type 2: Genital Herpes– Sexually transmitted

WartsWartsCaused by HPVCaused by HPVGeneral Tx: General Tx: – Salicylic Acid, Duck Tape, Liquid NitrogenSalicylic Acid, Duck Tape, Liquid Nitrogen

Common Wart:Common Wart:– Small, round elevated lesionSmall, round elevated lesion– Rough, dry surfaceRough, dry surface– Usually go away on their own within 18-24moUsually go away on their own within 18-24mo

Plantar Wart:Plantar Wart:– Found on bottom of footFound on bottom of foot– PainfulPainful– Wear sandals in Wear sandals in locker rooms/community showerslocker rooms/community showers

Cold Sensitivity/ReactionCold Sensitivity/Reaction

Cold Urticaria Cold Urticaria - Allergic Reaction w/ Hives- Allergic Reaction w/ Hives– Can be life-threateningCan be life-threatening– Redness, hives & itchingRedness, hives & itching– Can affect some areas and not othersCan affect some areas and not others

Can be hypersensitive without allergyCan be hypersensitive without allergy– Redness & painRedness & pain

Poison Oak/Ivy/SumacPoison Oak/Ivy/SumacCauses: Causes: – Direct contact with plantDirect contact with plant– Inhalation or skin exposure to airborne oil particles of Inhalation or skin exposure to airborne oil particles of

burning plantburning plant– Contact with contaminated materialsContact with contaminated materials

Sx’s:Sx’s: Within 12-48 hrs Within 12-48 hrs– Burning, itching, redness, rash, swelling blisters, high Burning, itching, redness, rash, swelling blisters, high

feverfever

Avoid scratching, ice, cold water?Avoid scratching, ice, cold water?

Cannot play with signs of serious infectionCannot play with signs of serious infection

May need to be cleared by physician for May need to be cleared by physician for wrestlingwrestling

Poison IvyPoison Ivy

Poison Oak/SumacPoison Oak/Sumac

Methicillin-resistant Methicillin-resistant Staphylococcus aureasStaphylococcus aureas

What is MRSAWhat is MRSAStaph InfectionStaph Infection

Bacteria that is resistant to certain antibioticsBacteria that is resistant to certain antibiotics– Methicillin, Penicillin, & AmoxicillinMethicillin, Penicillin, & Amoxicillin

Became increasingly common in hospital Became increasingly common in hospital setting in 1970’ssetting in 1970’s

MRSA-CA MRSA-CA (Community Acquired): (Community Acquired): emerged in 1990’semerged in 1990’s

May cause more serious infections:May cause more serious infections:– BloodBlood– PneumoniaPneumonia

How bad is CA-MRSA?How bad is CA-MRSA?

Most are minor infections and can be treated Most are minor infections and can be treated with an antibiotic creamwith an antibiotic cream

Some may require treatment w/ oral antibioticsSome may require treatment w/ oral antibiotics

A small percentage can be LIFE A small percentage can be LIFE THREATENINGTHREATENING

All MRSA infections should be evaluated by a All MRSA infections should be evaluated by a healthcare providerhealthcare provider– If the condition worsens you need to seek If the condition worsens you need to seek

immediate treatmentimmediate treatment

Who Gets MRSAWho Gets MRSA

Heathcare workers: 1:3Heathcare workers: 1:3

College & HS athletesCollege & HS athletes

InmatesInmates

Military recruits Military recruits

Daycare kidsDaycare kids

People in crowded conditionsPeople in crowded conditions

CA-MRSA BreakdownCA-MRSA Breakdown

Skin infectionsSkin infections 1,266 1,266 (77%)(77%)Wound (traumatic)Wound (traumatic) 157157 (10%)(10%)Urinary tract infectionUrinary tract infection 6464 (4%)(4%)SinusitisSinusitis 6161 (4%)(4%)BacteremiaBacteremia 4343 (3%)(3%)PneumoniaPneumonia 3131 (2%)(2%)

-Mostly skin infections-Mostly skin infections

MRSA Infections StatisticsMRSA Infections Statistics

Community

Healthcare

In 2007: In 2007: – 86% Healthcare Associated86% Healthcare Associated– 14% Community Associated14% Community Associated

In 2005: 94,350 serious infectionsIn 2005: 94,350 serious infections– ~18,650 people died ~18,650 people died – Mostly older Mostly older

persons (>65 y/o)persons (>65 y/o)

How is MRSA SpreadHow is MRSA SpreadBacteria is commonly carried on the skin Bacteria is commonly carried on the skin or in the nose of healthy individualsor in the nose of healthy individuals– 25% to 30% of the population are “colonized”25% to 30% of the population are “colonized”

Skin to skin contactSkin to skin contactCrowed living conditionsCrowed living conditionsSkin openings (cuts/abrasions)Skin openings (cuts/abrasions)Infected items (sports gear and clothing)Infected items (sports gear and clothing)Contaminated surfaces (weight room Contaminated surfaces (weight room equipment)equipment)Poor hygienePoor hygiene

What does MRSA look like?What does MRSA look like?

Skin can be: Skin can be: – Red or swollenRed or swollen– PainfulPainful– Pus or other drainagePus or other drainage

MRSAMRSA can live for months on MRSA can live for months on surfaces and fabrics:surfaces and fabrics: – Up to 7 months on dustUp to 7 months on dust– Up to 8 weeks on a mop headUp to 8 weeks on a mop head– Up to 9 weeks on cotton (towel)Up to 9 weeks on cotton (towel)– Up to 203 days (over 6 months) on a Up to 203 days (over 6 months) on a

blanketblanket

– MRSA can live on the skin of otherwise MRSA can live on the skin of otherwise healthy individuals, with no symptoms healthy individuals, with no symptoms indefinitely indefinitely

How do I prevent MRSA?How do I prevent MRSA?

Wash your handsWash your hands

Don’t share gear/clothingDon’t share gear/clothing

Clean sports gear oftenClean sports gear often

Tell ATC about skin woundsTell ATC about skin wounds

Keep cuts clean and coveredKeep cuts clean and covered

Don’t touch someone else’s Don’t touch someone else’s wounds/bandageswounds/bandages

Use a moisturizer to prevent cracking if the Use a moisturizer to prevent cracking if the skin is dryskin is dry

Athlete’s With MRSAAthlete’s With MRSAWound should be completely covered Wound should be completely covered – Cannot participate if the wound drainage cannot Cannot participate if the wound drainage cannot

be containedbe contained

Do not share equipment/clothing/towelsDo not share equipment/clothing/towels

Clean off equipment after useClean off equipment after use

If athlete is unable to maintain good personal If athlete is unable to maintain good personal hygiene, they should be removed from hygiene, they should be removed from participation until the infection clearsparticipation until the infection clears