Sports DermatologySports Dermatology
Kevin deWeber, MD, FAAFPKevin deWeber, MD, FAAFP
DirectorDirector
Primary Care Sports...
ObjectivesObjectives
Review common dermatologic problemsReview common dermatologic problems
and how they affect athletesan...
IntroductionIntroduction
DefinitionsDefinitions
FeetFeet
GroinGroin
ButtocksButtocks
HandsHands
FaceFace
GeneralGeneral
Ch...
DefinitionsDefinitions
Macule – not raised, 1 cm or lessMacule – not raised, 1 cm or less
Patch – not raised, greater than...
DefinitionsDefinitions
Vesicle - fluid filled, 1 cm or lessVesicle - fluid filled, 1 cm or less
Bulla - fluid filled, grea...
DefinitionsDefinitions
Crust - dried fluid, e.g. scabCrust - dried fluid, e.g. scab
Comedones -plugged sebaceousComedones ...
Impact of skin infections in NCAAImpact of skin infections in NCAA
wrestlerswrestlers
15% of practice time-loss injuries15...
National Federation of High SchoolsNational Federation of High Schools
Communicable Disease ProceduresCommunicable Disease...
CornsCorns
HyperkeratoticHyperkeratotic
pressure areapressure area
hard conical papulehard conical papule
with translucent...
Plantar WartsPlantar Warts
HPVHPV
thickened plantarthickened plantar
papules, shavepapules, shave
reveals “black dots”reve...
““Black Heel”Black Heel”
Traumatic micro-Traumatic micro-
hemorrhageshemorrhages
small asymptomaticsmall asymptomatic
blac...
BlistersBlisters
excessive frictionexcessive friction
vesicles and bullaevesicles and bullae
TX: prevention,TX: prevention...
Ingrown ToenailIngrown Toenail
From improperlyFrom improperly
fitting footwearfitting footwear
usually great toeusually gr...
Black ToenailsBlack Toenails
AKA “joggers toe”,AKA “joggers toe”,
“skiers toe”, “tennis toe”“skiers toe”, “tennis toe”
Fro...
OnychomycosisOnychomycosis
fungal infection of nailfungal infection of nail
discoloration, scaling,discoloration, scaling,...
Molluscum ContagiosumMolluscum Contagiosum
““wrestler’s warts”wrestler’s warts”
poxviruspoxvirus
firm, skin colored,firm, ...
ScabiesScabies
mitemite Sarcopetes scabieiSarcopetes scabiei
exquisitely pruriticexquisitely pruritic
papules, excoriation...
Genital WartsGenital Warts
Condyloma acuminataCondyloma acuminata
HPV, smooth orHPV, smooth or
verrucous papulesverrucous ...
Genital HerpesGenital Herpes
Small, groupedSmall, grouped
vesiclesvesiclespainful ulcers;painful ulcers;
DX: Tzanck prep...
Herpes infections:Herpes infections:
NCAA participation criteriaNCAA participation criteria
Primary infectionPrimary infec...
Tinea CrurisTinea Cruris
AKA “jock itch”AKA “jock itch”
Dermatophyte infectionDermatophyte infection
Erythematous w/Erythe...
Tinea Infections:Tinea Infections:
NCAA participation criteriaNCAA participation criteria
>72 hours treatment>72 hours tre...
ErythrasmaErythrasma
CorynebacteriumCorynebacterium
infectioninfection
Uniformly brown andUniformly brown and
scaly w/o ad...
Hidradenitis SuppuritivaHidradenitis Suppuritiva
blockage of sweatblockage of sweat
glands with secondaryglands with secon...
Tinea VersicolorTinea Versicolor
Pityrosporum ovalePityrosporum ovale,,
asymptomaticasymptomatic
Hypo- or hyper-pigmentedH...
Jogger’sJogger’s
NipplesNipples
irritation and friction,irritation and friction,
long distancelong distance
runnersrunners...
Warts, Verruca VulgarisWarts, Verruca Vulgaris
HPV; unsightly andHPV; unsightly and
painfulpainful
““black dots” afterblac...
Herpetic WhitlowHerpetic Whitlow
Tender erythematousTender erythematous
vesicles near fingertipvesicles near fingertip
TX:...
Dyshydrotic EczemaDyshydrotic Eczema
unknown etiology,unknown etiology,
not infectiousnot infectious
eczematouseczematous
...
Dermatophytid ReactionDermatophytid Reaction
distant site fungaldistant site fungal
infectioninfection
vesicularvesicular
...
ParonychiaParonychia
bacterial infectionbacterial infection
tender inflammationtender inflammation
of nail foldof nail fol...
Bacterial Infections:Bacterial Infections:
NCAA participation criteriaNCAA participation criteria
No new lesions for 48 ho...
Herpes LabialisHerpes Labialis
““cold sore”cold sore”
Herpes simplex virusHerpes simplex virus
VesiclesVesiclesulcers ne...
Acne VulgarisAcne Vulgaris
Acne Mechanica,Acne Mechanica,
“football acne”“football acne”
TX: topical Retin-A,TX: topical R...
Herpes GladiatorumHerpes Gladiatorum
HSV on area ofHSV on area of
friction/traumafriction/trauma
TX: oral antiviralsTX: or...
CellulitisCellulitis
Infection of dermis andInfection of dermis and
sub-cu tissuesub-cu tissue
Expanding erythema,Expandin...
ErysipelasErysipelas
Usually Gp A StrepUsually Gp A Strep
Superficial infectionSuperficial infection
extending into theext...
ImpetigoImpetigo
superficial skinsuperficial skin
infection with Strep,infection with Strep,
StaphStaph
yellow crustedyell...
FolliculitisFolliculitis
Mild hair follicleMild hair follicle
inflammation or infection,inflammation or infection,
usually...
FurunclesFuruncles
More severe hairMore severe hair
follicle abscess withfollicle abscess with
StaphStaph
acute, tender,ac...
CarbuncleCarbuncle
More extensiveMore extensive
abscess thanabscess than
furuncle; Staphfuruncle; Staph
TX: I&D, oral or I...
Methicillin-Resistant Staph AureusMethicillin-Resistant Staph Aureus
“MRSA”“MRSA”
Staph strains resistant toStaph strains ...
Methicillin-Resistant Staph AureusMethicillin-Resistant Staph Aureus
“MRSA”“MRSA”
When to suspectWhen to suspect
– Skin ab...
Methicillin-Resistant Staph AureusMethicillin-Resistant Staph Aureus
“MRSA”“MRSA”
PreventionPrevention
– No participation ...
Varicella (chickenpox)Varicella (chickenpox)
Varicella zoster virusVaricella zoster virus
Lesions in various stages—Lesion...
Miliaria RubraMiliaria Rubra
“prickly heat”“prickly heat”
sweat duct occlusionsweat duct occlusion
fine erythematousfine e...
Contact DermatitisContact Dermatitis
direct chemical irritantdirect chemical irritant
or allergic delayed rxnor allergic d...
Atopic DermatitisAtopic Dermatitis
dry easily irritateddry easily irritated
skin, worsened byskin, worsened by
heat and sw...
SunburnSunburn
UV radiationUV radiation
mild to intensemild to intense
erythemaerythema
analgesics, coolanalgesics, cool
c...
PhotosensitivityPhotosensitivity
ReactionsReactions
reaction to sun or Rxreaction to sun or Rx
eczema-like rash ineczema-l...
Striae DistensaeStriae Distensae
rupture of elasticrupture of elastic
fibers from rapidfibers from rapid
growth; steroids?...
ConclusionConclusion
Skin diseases in athletes can be sportsSkin diseases in athletes can be sports
and regionally specifi...
Sports Dermatology
Sports Dermatology
Sports Dermatology
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Sports Dermatology

  1. 1. Sports DermatologySports Dermatology Kevin deWeber, MD, FAAFPKevin deWeber, MD, FAAFP DirectorDirector Primary Care Sports Medicine FellowshipPrimary Care Sports Medicine Fellowship Military Sports Medicine Fellowship “Every Warrior an Athlete”
  2. 2. ObjectivesObjectives Review common dermatologic problemsReview common dermatologic problems and how they affect athletesand how they affect athletes Discuss skin disorders specific toDiscuss skin disorders specific to athletesathletes Review diagnostic keys and treatmentsReview diagnostic keys and treatments of athletic dermatologic concernsof athletic dermatologic concerns
  3. 3. IntroductionIntroduction DefinitionsDefinitions FeetFeet GroinGroin ButtocksButtocks HandsHands FaceFace GeneralGeneral Chest and BackChest and Back
  4. 4. DefinitionsDefinitions Macule – not raised, 1 cm or lessMacule – not raised, 1 cm or less Patch – not raised, greater than 1 cmPatch – not raised, greater than 1 cm Papule - raised, 1 cm or lessPapule - raised, 1 cm or less Plaque - flat elevation, greater than 1 cmPlaque - flat elevation, greater than 1 cm Nodule – rounded elevation, greater thanNodule – rounded elevation, greater than 1 cm1 cm Tumor – large noduleTumor – large nodule
  5. 5. DefinitionsDefinitions Vesicle - fluid filled, 1 cm or lessVesicle - fluid filled, 1 cm or less Bulla - fluid filled, greater than 1 cmBulla - fluid filled, greater than 1 cm Pustule - elevated, pus filledPustule - elevated, pus filled Wheal – firm edematous plaque,Wheal – firm edematous plaque, transienttransient
  6. 6. DefinitionsDefinitions Crust - dried fluid, e.g. scabCrust - dried fluid, e.g. scab Comedones -plugged sebaceousComedones -plugged sebaceous folliclesfollicles Scale - excess keratinScale - excess keratin Excoriation - erosion from scratchingExcoriation - erosion from scratching Erosion - partial thickness lossErosion - partial thickness loss Ulcer - erosion into dermisUlcer - erosion into dermis Fissure - crack-like break into dermisFissure - crack-like break into dermis
  7. 7. Impact of skin infections in NCAAImpact of skin infections in NCAA wrestlerswrestlers 15% of practice time-loss injuries15% of practice time-loss injuries
  8. 8. National Federation of High SchoolsNational Federation of High Schools Communicable Disease ProceduresCommunicable Disease Procedures HCP must evaluate skin lesions beforeHCP must evaluate skin lesions before returning to competitionreturning to competition Consider evaluating other teamConsider evaluating other team membersmembers Follow state/local “return to competition”Follow state/local “return to competition” rulesrules
  9. 9. CornsCorns HyperkeratoticHyperkeratotic pressure areapressure area hard conical papulehard conical papule with translucentwith translucent centercenter TX: modify foot wearTX: modify foot wear to change pressure,to change pressure, soften lesion,soften lesion, removeremove
  10. 10. Plantar WartsPlantar Warts HPVHPV thickened plantarthickened plantar papules, shavepapules, shave reveals “black dots”reveals “black dots” TX: keratolyticTX: keratolytic solutions,solutions, podophyllin,podophyllin, cryotherapycryotherapy
  11. 11. ““Black Heel”Black Heel” Traumatic micro-Traumatic micro- hemorrhageshemorrhages small asymptomaticsmall asymptomatic black maculesblack macules no treatment neededno treatment needed
  12. 12. BlistersBlisters excessive frictionexcessive friction vesicles and bullaevesicles and bullae TX: prevention,TX: prevention, drainage (leave thedrainage (leave the roof), hydrocolloidroof), hydrocolloid dressing (duoderm)dressing (duoderm)
  13. 13. Ingrown ToenailIngrown Toenail From improperlyFrom improperly fitting footwearfitting footwear usually great toeusually great toe TX:TX: – pressure relief (gopressure relief (go shoeless, widershoeless, wider shoes)shoes) – cotton under nailcotton under nail – Antibiotics if infectedAntibiotics if infected – surgical excisionsurgical excision
  14. 14. Black ToenailsBlack Toenails AKA “joggers toe”,AKA “joggers toe”, “skiers toe”, “tennis toe”“skiers toe”, “tennis toe” From trauma or pressureFrom trauma or pressure TX:TX: – acute subungualacute subungual hematoma: pierce nailhematoma: pierce nail – Mild cases: no txMild cases: no tx – Prevention: proper shoes,Prevention: proper shoes, metatarsal padmetatarsal pad
  15. 15. OnychomycosisOnychomycosis fungal infection of nailfungal infection of nail discoloration, scaling,discoloration, scaling, thickeningthickening culture before txculture before tx TX:TX: – Dermatophytes: SystemicDermatophytes: Systemic itraconazole or terbinafineitraconazole or terbinafine 2-4 mos2-4 mos – Mold: topicalsMold: topicals – Candida: topical orCandida: topical or systemicsystemic
  16. 16. Molluscum ContagiosumMolluscum Contagiosum ““wrestler’s warts”wrestler’s warts” poxviruspoxvirus firm, skin colored,firm, skin colored, umbilicatedumbilicated papulespapules TX: spontaneous resolutionTX: spontaneous resolution (months), curettage,(months), curettage, topicals, cryotherapytopicals, cryotherapy NCAA:NCAA: – curette or remove lesions &curette or remove lesions & – cover with gas-permcover with gas-perm membrane AND tapemembrane AND tape
  17. 17. ScabiesScabies mitemite Sarcopetes scabieiSarcopetes scabiei exquisitely pruriticexquisitely pruritic papules, excoriations;papules, excoriations; DX: scrapingDX: scraping TX: topical permethrinTX: topical permethrin or crotamiton overnightor crotamiton overnight NCAA - verification ofNCAA - verification of treatment and negativetreatment and negative scrapingsscrapings
  18. 18. Genital WartsGenital Warts Condyloma acuminataCondyloma acuminata HPV, smooth orHPV, smooth or verrucous papulesverrucous papules genital and perianalgenital and perianal regions, clusterregions, cluster TX: cryotherapy; topicalTX: cryotherapy; topical podophyllox, imiquimodpodophyllox, imiquimod 5% cream5% cream
  19. 19. Genital HerpesGenital Herpes Small, groupedSmall, grouped vesiclesvesiclespainful ulcers;painful ulcers; DX: Tzanck prepDX: Tzanck prep TX: acyclovir, valacyclovirTX: acyclovir, valacyclovir NCAA: see HerpesNCAA: see Herpes InfectionsInfections
  20. 20. Herpes infections:Herpes infections: NCAA participation criteriaNCAA participation criteria Primary infectionPrimary infection – no systemic sxsno systemic sxs – no new lesions x 3 daysno new lesions x 3 days – all lesions crustedall lesions crusted – on oral meds >120 hours ( 5 days)on oral meds >120 hours ( 5 days) – Crusts coveredCrusts covered Recurrent infectionRecurrent infection – Ulcers dry, covered by FIRM ADHERENT CRUSTUlcers dry, covered by FIRM ADHERENT CRUST – On oral meds for >120 hoursOn oral meds for >120 hours – Crusts coveredCrusts covered
  21. 21. Tinea CrurisTinea Cruris AKA “jock itch”AKA “jock itch” Dermatophyte infectionDermatophyte infection Erythematous w/Erythematous w/ advancing border,advancing border, pruritic; DX: KOH preppruritic; DX: KOH prep TX: topical antifungalsTX: topical antifungals NCAA: see TineaNCAA: see Tinea InfectionsInfections
  22. 22. Tinea Infections:Tinea Infections: NCAA participation criteriaNCAA participation criteria >72 hours treatment>72 hours treatment DQ if extensive lesionsDQ if extensive lesions Cover lesions with OpSite and tapeCover lesions with OpSite and tape after washing with Ketoconazoleafter washing with Ketoconazole shampoo and applying antifungal creamshampoo and applying antifungal cream
  23. 23. ErythrasmaErythrasma CorynebacteriumCorynebacterium infectioninfection Uniformly brown andUniformly brown and scaly w/o advancingscaly w/o advancing border; coral-red underborder; coral-red under Wood’s lampWood’s lamp TX: oral or topicalTX: oral or topical erythromycinerythromycin NCAA: see BacterialNCAA: see Bacterial InfectionsInfections
  24. 24. Hidradenitis SuppuritivaHidradenitis Suppuritiva blockage of sweatblockage of sweat glands with secondaryglands with secondary infection; chronic sinusinfection; chronic sinus tracts can formtracts can form Erythematous papules,Erythematous papules, nodules, drainagenodules, drainage TX:TX: topical +/- oral abxtopical +/- oral abx I&DI&D Surgical excisionSurgical excision
  25. 25. Tinea VersicolorTinea Versicolor Pityrosporum ovalePityrosporum ovale,, asymptomaticasymptomatic Hypo- or hyper-pigmentedHypo- or hyper-pigmented macules; DX: Wood’smacules; DX: Wood’s lamp, KOH scrapelamp, KOH scrape TX: Selenium sulfideTX: Selenium sulfide shampoo, -azole creams,shampoo, -azole creams, terbinafine cream;terbinafine cream; itraconazole oralitraconazole oral NCAA: see TineaNCAA: see Tinea InfectionsInfections
  26. 26. Jogger’sJogger’s NipplesNipples irritation and friction,irritation and friction, long distancelong distance runnersrunners painful, fissured,painful, fissured, eroded nippleseroded nipples TX: soft fiber shirts,TX: soft fiber shirts, adhesive bandages,adhesive bandages, petroleum jellypetroleum jelly
  27. 27. Warts, Verruca VulgarisWarts, Verruca Vulgaris HPV; unsightly andHPV; unsightly and painfulpainful ““black dots” afterblack dots” after shave-downshave-down TX: salicylic acidTX: salicylic acid patch, cryotherapy,patch, cryotherapy, occlusionocclusion NCAA: cover prior toNCAA: cover prior to competitioncompetition
  28. 28. Herpetic WhitlowHerpetic Whitlow Tender erythematousTender erythematous vesicles near fingertipvesicles near fingertip TX: oral antiviralsTX: oral antivirals NCAANCAA – See Herpes Infections,See Herpes Infections, recurrentrecurrent
  29. 29. Dyshydrotic EczemaDyshydrotic Eczema unknown etiology,unknown etiology, not infectiousnot infectious eczematouseczematous eruption of pruriticeruption of pruritic vesicles on fingersvesicles on fingers TX: keep hands dry,TX: keep hands dry, lotions, topicallotions, topical steroidssteroids
  30. 30. Dermatophytid ReactionDermatophytid Reaction distant site fungaldistant site fungal infectioninfection vesicularvesicular treat distant site,treat distant site, consider prednisoneconsider prednisone NCAA: see tineasNCAA: see tineas
  31. 31. ParonychiaParonychia bacterial infectionbacterial infection tender inflammationtender inflammation of nail foldof nail fold TX: warm soaks,TX: warm soaks, I&D, +/- oral abxI&D, +/- oral abx NCAA: see BacterialNCAA: see Bacterial InfectionsInfections
  32. 32. Bacterial Infections:Bacterial Infections: NCAA participation criteriaNCAA participation criteria No new lesions for 48 hoursNo new lesions for 48 hours >72 hours of antibiotics completed>72 hours of antibiotics completed No moist, exudative or draining lesionsNo moist, exudative or draining lesions Active bacterial infections shall NOT beActive bacterial infections shall NOT be covered to allow participation if abovecovered to allow participation if above criteria not metcriteria not met
  33. 33. Herpes LabialisHerpes Labialis ““cold sore”cold sore” Herpes simplex virusHerpes simplex virus VesiclesVesiclesulcers nearulcers near lip; painfullip; painful TX: topical or oralTX: topical or oral antivirals, sunscreen toantivirals, sunscreen to prevent; considerprevent; consider prophylactic valacyclovirprophylactic valacyclovir NCAA: see HerpesNCAA: see Herpes InfectionsInfections
  34. 34. Acne VulgarisAcne Vulgaris Acne Mechanica,Acne Mechanica, “football acne”“football acne” TX: topical Retin-A,TX: topical Retin-A, benzoyl peroxide,benzoyl peroxide, abx; oral abxabx; oral abx Not aNot a contraindication tocontraindication to sportssports
  35. 35. Herpes GladiatorumHerpes Gladiatorum HSV on area ofHSV on area of friction/traumafriction/trauma TX: oral antiviralsTX: oral antivirals NCAA – see HerpesNCAA – see Herpes InfectionsInfections
  36. 36. CellulitisCellulitis Infection of dermis andInfection of dermis and sub-cu tissuesub-cu tissue Expanding erythema,Expanding erythema, swelling, tendernessswelling, tenderness TX: rest, elevation, oralTX: rest, elevation, oral abx; IV abx if severe orabx; IV abx if severe or on faceon face NCAA: see BacterialNCAA: see Bacterial InfectionsInfections
  37. 37. ErysipelasErysipelas Usually Gp A StrepUsually Gp A Strep Superficial infectionSuperficial infection extending into theextending into the lymphatics; systemiclymphatics; systemic sxs commonsxs common More red, swollen thanMore red, swollen than cellulitis, somecellulitis, some streakingstreaking TX: penicillins, AzithroTX: penicillins, Azithro NCAA: see BacterialNCAA: see Bacterial InfectionsInfections
  38. 38. ImpetigoImpetigo superficial skinsuperficial skin infection with Strep,infection with Strep, StaphStaph yellow crustedyellow crusted lesions on red baselesions on red base TX: remove crust;TX: remove crust; topical mupirocin ortopical mupirocin or oral abxoral abx NCAA – seeNCAA – see Bacterial InfectionsBacterial Infections
  39. 39. FolliculitisFolliculitis Mild hair follicleMild hair follicle inflammation or infection,inflammation or infection, usually Staphusually Staph – Pseudomonas in hot tubsPseudomonas in hot tubs Papules, pustules aroundPapules, pustules around folliclesfollicles TX: wash with soap,TX: wash with soap, topical mupirocin, oral abxtopical mupirocin, oral abx NCAA: see BacterialNCAA: see Bacterial InfectionsInfections
  40. 40. FurunclesFuruncles More severe hairMore severe hair follicle abscess withfollicle abscess with StaphStaph acute, tender,acute, tender, erythematous noduleerythematous nodule TX: warm compresses,TX: warm compresses, abx, I&Dabx, I&D NCAA – see BacterialNCAA – see Bacterial InfectionsInfections
  41. 41. CarbuncleCarbuncle More extensiveMore extensive abscess thanabscess than furuncle; Staphfuruncle; Staph TX: I&D, oral or IVTX: I&D, oral or IV abxabx NCAA: see BacterialNCAA: see Bacterial InfectionsInfections
  42. 42. Methicillin-Resistant Staph AureusMethicillin-Resistant Staph Aureus “MRSA”“MRSA” Staph strains resistant toStaph strains resistant to ß-lactam abx (e.g.ß-lactam abx (e.g. dicloxacillin, methicillin)dicloxacillin, methicillin) May be resistant to other abxMay be resistant to other abx Cause skin infections usuallyCause skin infections usually – Cellulitis, folliculitis, furuncles, abscessesCellulitis, folliculitis, furuncles, abscesses Cause significant morbidityCause significant morbidity – 70% of athletes required IV abx70% of athletes required IV abx Spread directly person-to-personSpread directly person-to-person – Football linemen, rugby, fencing, wrestlingFootball linemen, rugby, fencing, wrestling – Through injured skinThrough injured skin
  43. 43. Methicillin-Resistant Staph AureusMethicillin-Resistant Staph Aureus “MRSA”“MRSA” When to suspectWhen to suspect – Skin abscessesSkin abscesses – Infections resistant to initial abxInfections resistant to initial abx Proper treatmentProper treatment – Culture all abscesses before txCulture all abscesses before tx – Susceptibility should guide abx choiceSusceptibility should guide abx choice Community-acquired strains usually sensitive toCommunity-acquired strains usually sensitive to SMX-TMP, fluoroquinolones, clindamycin, e-SMX-TMP, fluoroquinolones, clindamycin, e- mycinmycin
  44. 44. Methicillin-Resistant Staph AureusMethicillin-Resistant Staph Aureus “MRSA”“MRSA” PreventionPrevention – No participation of infected athletes untilNo participation of infected athletes until curedcured – Protect exposed skin if high-risk sportProtect exposed skin if high-risk sport – Properly clean/protect injured skinProperly clean/protect injured skin – Proper general hygieneProper general hygiene – Report MRSA to PrevMed and CDCReport MRSA to PrevMed and CDC
  45. 45. Varicella (chickenpox)Varicella (chickenpox) Varicella zoster virusVaricella zoster virus Lesions in various stages—Lesions in various stages— papules, vesicles, ulcers,papules, vesicles, ulcers, crusts on red basescrusts on red bases TX: oral antivirals if early;TX: oral antivirals if early; supportive measures; itchsupportive measures; itch creamscreams NCAA: no participation untilNCAA: no participation until ALL lesions crusted firmly,ALL lesions crusted firmly, no secondary bacterialno secondary bacterial infectioninfection
  46. 46. Miliaria RubraMiliaria Rubra “prickly heat”“prickly heat” sweat duct occlusionsweat duct occlusion fine erythematousfine erythematous papulespapules TX: dry clothing,TX: dry clothing, hydrophilichydrophilic ointmentsointments
  47. 47. Contact DermatitisContact Dermatitis direct chemical irritantdirect chemical irritant or allergic delayed rxnor allergic delayed rxn pruritic patches ofpruritic patches of vesicles on weepingvesicles on weeping basebase TX: calamine lotion,TX: calamine lotion, benadryl, topicalbenadryl, topical steroids; Zanfel creamsteroids; Zanfel cream
  48. 48. Atopic DermatitisAtopic Dermatitis dry easily irritateddry easily irritated skin, worsened byskin, worsened by heat and sweatheat and sweat pruritic erythematouspruritic erythematous macules and patches,macules and patches, flexor surfacesflexor surfaces TX: moisturizers,TX: moisturizers, topical steroids, soap-topical steroids, soap- free cleansingfree cleansing
  49. 49. SunburnSunburn UV radiationUV radiation mild to intensemild to intense erythemaerythema analgesics, coolanalgesics, cool compresses, topicalcompresses, topical steroids or lotionssteroids or lotions
  50. 50. PhotosensitivityPhotosensitivity ReactionsReactions reaction to sun or Rxreaction to sun or Rx eczema-like rash ineczema-like rash in sun-exposed areassun-exposed areas TX:TX: – stop offending medstop offending med – protect skin from sunprotect skin from sun – topical &/or oraltopical &/or oral steroidssteroids
  51. 51. Striae DistensaeStriae Distensae rupture of elasticrupture of elastic fibers from rapidfibers from rapid growth; steroids?growth; steroids? perpendicular toperpendicular to lines of tension;lines of tension; shoulders, back,shoulders, back, thighthigh no good treatmentno good treatment provenproven
  52. 52. ConclusionConclusion Skin diseases in athletes can be sportsSkin diseases in athletes can be sports and regionally specificand regionally specific Recognize and treat earlyRecognize and treat early Know the rules for participationKnow the rules for participation

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