Common skin Common skin conditions in conditions in

wrestlingwrestling

RingwormRingwormImpetigoImpetigoMulluscum ContagiosumMulluscum ContagiosumHerpes GladiatorumHerpes Gladiatorum

Skin ConditionsSkin Conditions

The skin conditions that follow are The skin conditions that follow are samples of those which you may see samples of those which you may see during the season. Any skin condition during the season. Any skin condition which has the potential of being which has the potential of being transmitted to an opponent should be transmitted to an opponent should be under the care of a physician before under the care of a physician before returning to practice or competition.returning to practice or competition.

Ringworm Ringworm (tinea corporis)(tinea corporis)

Ringworm-Ringworm-– Raised circular patches at edgesRaised circular patches at edges– Central portion is usually flatCentral portion is usually flat– Not from the mat surfaceNot from the mat surface– Skin to skin contact with infected Skin to skin contact with infected

individualsindividuals

RingwormRingwormCare Care

Oral/topical treatment for 7days Oral/topical treatment for 7days for skin lesions before wrestlingfor skin lesions before wrestling

Covered with bioclusive plus pre-Covered with bioclusive plus pre-wrap and tape for extremities, wrap and tape for extremities, may wrestlemay wrestle

Face and scalp may not have Face and scalp may not have contact until lesion is flat????contact until lesion is flat????

Ringworm Ringworm CareCare

TopicalTopical– Lamisil 1%, Mentax 1%, Naftin 1%, Lamisil 1%, Mentax 1%, Naftin 1%,

Spectazole 1% cream 2x per daySpectazole 1% cream 2x per day– Continue treatment for 1 week after Continue treatment for 1 week after

lesion is gonelesion is gone

RingwormRingwormCareCare

Oral medicationsOral medications– Lamisil 250mgs per day for 2 weeksLamisil 250mgs per day for 2 weeks– Sporanox 200 mgs per day for 2 Sporanox 200 mgs per day for 2

weeksweeks– Diflucan 200 mgs once a week for 3 Diflucan 200 mgs once a week for 3

weeksweeks

Ringworm appearanceRingworm appearance

RingwormRingworm

RingwormRingworm

ImpetigoImpetigo Bacterial infection (streptococcus Bacterial infection (streptococcus

or staphylococcus aureus)or staphylococcus aureus) Extremely contagiousExtremely contagious May be spread on mat surfaceMay be spread on mat surface Associated with minor skin Associated with minor skin

trauma or secondary to viral trauma or secondary to viral infectionsinfections

ImpetigoImpetigo

Honey coloredHoney colored Wet, moist lesionsWet, moist lesions

ImpetigoImpetigoCareCare

Prescription Topical antibiotic: Prescription Topical antibiotic: Mupirocin (Bactroban)Mupirocin (Bactroban)

Oral antibiotic for 72 hours prior Oral antibiotic for 72 hours prior to contact to contact

May not cover and wrestle May not cover and wrestle No oozing, draining or moist No oozing, draining or moist

lesionslesions

ImpetigoImpetigoCareCare

Keflex 500 mgs 2x/day for 10 Keflex 500 mgs 2x/day for 10 daysdays

Pen VK 500 mgs 4x/day for 10 Pen VK 500 mgs 4x/day for 10 daysdays

Clindamycin 300 mgs 4x/day for Clindamycin 300 mgs 4x/day for 10 days10 days

ImpetigoImpetigo

ImpetigoImpetigo

Molluscum Molluscum ContagiosumContagiosum Pox virusPox virus Treat to prevent transmissionTreat to prevent transmission Central umblication, belly button Central umblication, belly button

appearanceappearance Contact contagiousContact contagious

Molluscum ContagiosumMolluscum ContagiosumCareCare

Must be curetted or removed Must be curetted or removed before meetbefore meet

Single or clustered lesions may be Single or clustered lesions may be covered by Bioclusive then pre-covered by Bioclusive then pre-wrap and tapewrap and tape

Molluscum Molluscum ContagiosumContagiosum

Molluscum Molluscum ContagiosumContagiosum

Molluscum Molluscum ContagiousumContagiousum

Herpes GladiatorumHerpes Gladiatorum

Cold sores or recurrent Cold sores or recurrent “impetigo”“impetigo”

73% occur on head or face73% occur on head or face 3-8 days after contact3-8 days after contact Only skin to skin , not from matsOnly skin to skin , not from mats Stress, cutting weight, abrasions Stress, cutting weight, abrasions

may cause recurrencemay cause recurrence

Herpes GladiatorumHerpes GladiatorumCareCare

No new and all lesions to be scabbed No new and all lesions to be scabbed overover

Must be on systemic antiviral for 148 Must be on systemic antiviral for 148 hours(7 days) before practice or hours(7 days) before practice or competitioncompetition

If no meds: no visible lesionsIf no meds: no visible lesions No covering of lesionsNo covering of lesions

Herpes GladiatorumHerpes GladiatorumSingle OutbreaksSingle Outbreaks

Isolate the wrestler, seek medical Isolate the wrestler, seek medical care, no contact activities, care, no contact activities, antiviral for 6 daysantiviral for 6 days

All wrestlers in contact up to 3 All wrestlers in contact up to 3 days prior should be isolated for 8 days prior should be isolated for 8 days and monitored for days and monitored for symptoms.symptoms.

Herpes GladiatorumHerpes Gladiatorum

Herpes GladiatorumHerpes Gladiatorum

Herpes GladiatorumHerpes Gladiatorum

Herpes vs ImpetigoHerpes vs Impetigo

Herpes: multiple areas of Herpes: multiple areas of vesicles, large lymph nodes, low vesicles, large lymph nodes, low grade fever, usually dominant grade fever, usually dominant side of wrestlerside of wrestler

Impetigo: large weeping areas, Impetigo: large weeping areas, honey colored, no small vesicles, honey colored, no small vesicles, crustiness covering the sitescrustiness covering the sites

Herpes vs ImpetigoHerpes vs Impetigo

ReferencesReferences http://www.nlm.nih.gov/medlinephttp://www.nlm.nih.gov/medlinep

lus/ency/article/001439.htmlus/ency/article/001439.htm http://www.webmd.com/skin-prohttp://www.webmd.com/skin-pro

blems-and-treatments/tc/ringworblems-and-treatments/tc/ringworm-of-the-skin-preventionm-of-the-skin-prevention

http://dermatology.about.com/http://dermatology.about.com/cs/fungalinfections/a/cs/fungalinfections/a/ringworm.htmringworm.htm

ReferencesReferences

http://www.emedicine.com/EMERhttp://www.emedicine.com/EMERG/topic246.htmG/topic246.htm

http://dermnetnz.org/viral/herpes-http://dermnetnz.org/viral/herpes-simplex.htmlsimplex.html

http://dermnetnz.org/viral/herpes-http://dermnetnz.org/viral/herpes-zoster.htmlzoster.html

ReferencesReferences

http://www.nlm.nih.gov/medlineplhttp://www.nlm.nih.gov/medlineplus/ency/article/000860.htmus/ency/article/000860.htm

http://www.webmd.com/a-to-z-guihttp://www.webmd.com/a-to-z-guides/impetigo-overviewdes/impetigo-overview