Skin Infections in Wrestling - CDWOAcdwoa.org/documents/SkinInfectionPresentation.pdf · Fungal •...
Transcript of Skin Infections in Wrestling - CDWOAcdwoa.org/documents/SkinInfectionPresentation.pdf · Fungal •...
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Skin Infections in Wrestling
Randall R. Wroble MDEric O. DeLeon MD
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• Tinea Lesions – ringworm of scalp or skin• Bacterial Disease – impetigo, boils• Conjuctivitis – Pink eye• Scabies, Head Lice• Molluscum Contagiosum
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Fungal
• Tinea pedis and cruris– “athlete’s foot” and “jock itch”– Itching, scaling, maceration, vesicles, bullae– Interdigital spaces, sole and arch; groin area– Dermatophytes:
• Trichophyton mentagrophytes• Trichophyton rubrum• Epidermophyton floccosum
– Septated hyphae seen on KOH prep
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Fungal• Tinea corporis
– “ringworm”; Tinea gladiatorum– Often grouped together, usually some itching– Pink-red annular raised patches, central clearing – Direct (other humans) and indirect (mats, etc.) acquisi– Dermatophytes:
• Trichophyton rubrum – most common• Trichophyton tonsurans – cultured in one outbreak among h• Microsporum canis – multiple lesions
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Fungal
• Tinea versicolor • Variable presentation
– Commensal yeast infection– Benign, self-limited disorder– Treatment:
• Selenium sulfite 2.5 % lotion (Selsun)• Applied neck > waist, 10 minutes/day x 7 days, then every • Imidazole creams and po prn severe cases
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Tinea corporis
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Ringworm
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Ringworm
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Ringworm
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Tinea pedis
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Tinea versicolor
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Bacterial• Impetigo – Staphylococci +/- Streptococci
– Face, nose, mouth, sites of trauma– Tender red papule > vesicle or bulla > pustule > weeping shallow ulcer >– “honey-colored” crust– Treat early and aggressively – can cause GMN
• Bid-tid cleansing w/ antibacterial soaps, chlorhexidine (Hibiclens)• Topical mupirocin (Bactroban) ointment tid x 7-10 days.• po antibiotics x 7-10 days
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Bacterial• Folliculitis
– Inflammation of hair follicles, often in clusters– Usually Staphylococci; local or widespread– Can progress to furuncles, abscesses– Treatment:
• Topical scrubs (chlorhexidine)• Topical antibiotic gel pads• Same po options as impetigo
– If recurrent - consider carrier status,– mupirocin nasal treatment,– ? underlying immune deficiency or systemic disease (DM)
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Furunculosis
• Furuncle/Abscess– Usually Staphylococci– +/- incision and drainage
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Abscess
• Furuncle/Abscess
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Bacterial
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Bacterial
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Viral• Herpes gladiatorum
– Herpes simplex 1 virus– College >> high school incidence– Head > extremities > trunk– Spreads very rapidly– Outbreaks reported (Belongia, et.al., 1991)– Less common in those with hx. cold sores (Becker et.a
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Herpes gladiatorum
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Herpes gladiatorum
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Herpes gladiatorum
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Herpes gladiatorum
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Rule 4.2.3
• NFHS skin condition form is the OHSAA form
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4.2.3 Documentation
• Pre-meet Designated Physician• Weigh-in OHSAA/NFHS form• New lesion, no form –NO Weigh-in• May weigh-in; awaiting designate physician
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Rule 4.2.4 Designated Physician• Verify prior to or upon arrival• On site physician over rule forms• May not leave wrestling location for evaluation or second opinion
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OHSAA
• Treatment start and when to return• Expiration 10 days after exam• No guidelines Rx
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4.2.5 Non-Contagious Condition
• Appropriate NFHS/OHSAA form• Exact Body gram• Specific condition named• Denote non-contagious• Lesion may become secondarily infectious• On site physician can over rule
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Guidelines
• Red• Raised (skin swollen, pustules)• Rough (skin flaking or irregular)• Runny (discharge of any color or colorless)
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• Review and Verify• Discovery and Determine• Protect all wrestlers • Safety for everyone to include officials
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Thank you!