Dermatological Considerations in the Athlete Flashcards
What are the three basic layers of the skin?
- Epidermis
- Dermis
- Subcutaneous
What are the five layers of the epidermis?
- stratum corneum
- stratum lucidum
- stratum granulosum
- stratum spinosum
- stratum basale
- Contains no blood vessels or lymphatics and therefore relies on the more vascular dermis for its supply of nutrients
Describe the Dermis
- Irregular dense layer of collagen and elastin fibers containing blood vessels, eccrine and apocrine sweat glands, nerve endings, hair follicles, and sebaceous glands
What is a Blister?
- Shearing forces result in separation of the stratum
spinosum in the epidermal layer, causing it to fill with transudate or blood due to the hydrostatic pressure.
What is the clinical presentation of a blister?
- Sharp, burning sensations, or a feeling of a “hot spot.”
- Once the friction blister matures, appears as a painful, clear fluid filled lesion (bulla) surrounded by erythema.
How is a small blister treated?
- Monitor, should resolve in a day or two
How is a Large blister treated?
- Wash with antiseptic soap
- Small incision along edge
- Evacuate fluid with infection
- Clean again, cover with antiseptic ointment
- Apply donut pad
- Repeat as needed
What is Hyperkeratosis (Callus)?
- When skin is exposed to constant friction, epidermal layer can thicken in a hyperkeratotic response known as a callus
How can painful calluses be treated?
- Apply urea cream or salycytic acid
- Rub pumice stone or emery file
- Or pare with scalpel but be careful not to remove entire callus
What are Corns?
- Form of Hyperkeratosis
- Occur over bony prominences and form as a result of ill-fitting shoes or poor biomechanics
Describe Corns
- Soft corns frequently found between the toes and are macerated from the moist environment.
- Hard corns resemble calluses but are smaller and more focal. They are typically found on the tops of toes, related to toe deformity such as hammer toes.
- Unlike calluses, corns are painful and can cause disability
What is the management for Corns?
- Correct faulty footwear or poor mechanics
- Toe separators and Orthotics
- If doesn’t work, refer to podiatrist
What is best prevention for Corns?
- Properly fitted shoes
What is Infertrigo?
- Chafing
- inflammation of the skin in body folds as a result of two skin surfaces rubbing together in areas like the groin or axilla
What is management of Infertrigo?
- Clean with soap and water
- Corticosteroid creams
What is best prevention for Infertrigo?
- Talcum Powder
- Petroleum Jelly
What is Acne Mechanica?
- Form of acne caused by heat, excessive pressure, and repetitive forces on the skin
- Causes are tight uniforms, headgear, and equipment pads and straps
What is presentation of Acne Mechanica?
- Well defined pustules and papules in the area where the equipment or clothing has irritated the skin
What is management of Acne Mechanica?
- Remove irritating cause
- Refer to derm for topical treatment
What are the two most common bacteria causing skin infection?
- Staphylococcus
- Streptococcus
Differentiate Primary and Secondary Impetigo
- Primary: Infection in area of normal, healthy skin
- Secondary: Infection where skin was previously disturbed (Abrasion, etc)
What are the three variants of Impetigo?
- Non-bullous
- Bullous
- Ecthyma
Describe Non-Bullous Impetigo
- Most often seen in children between two and five years of age
- Most commonly affected areas are the face around the mouth and nose, and the extremities
- Evolves from red papules to vesicles to pustules that then break, creating a nonpainful, crusting, honey-colored lesion
- Caused by S. aureus or S. pyogenes.
Describe Bullous Impetigo
- Presents initially with a large thin walled bulla containing yellow-colored fluid
- Most commonly affected areas are the trunk and buttocks
- Often, bulla breaks, leaving a lesion in the shape of
an arch - Cause only by S. Aureus