Skin Conditions Flashcards
Organizations Managing Athlete Participation
NCAA and NFHS
What are the layers of the skin?
- Epidermis:
- Stratum corneal (top layer)
- Squamous cells (middle layer)
- Basal cells (deep layer) - Dermis
- Hypodermis (Has adipose tissue)
- Muscle
What are roles of skin?
- Thermoregulation
- Protection
How often should these things be cleaned:
1. Shower room in public locker room?
2. Locker room surfaces (benches, walls, mirrors, floors)?
3. Wrestling room?
4. Wrestling weight room
5. Wrestling treatment/taping tables
6. Wrestling support areas
7. Steam room/sauna
8. Carpeting
- 1x/day
- 1x/day
- Walls and mats on walls = 1x/day; Mats (3x/day)
- 1x/day where bodies touch equipment
- 1x/day
- Stairs and public areas = 1x/day
- 1x/day
- Extracting: monthly; vacuuming = 1x/day
Categories of infectious skin conditions
- Bacterial
- Fungal
- Viral
Infections bacterial infections?
- MRSA
- Impetigo
- Furuncles and carbuncles
- Folliculitis
How to identify MRSA? Treatment?
- Often mistaken as spider bite
- Swollen, red painful bump that looks like boil or insect bite
- Can turn into a cluster of pimples
Treat with antimicrobial agents
Impetigo:
1. What is it?
2. How to identify?
3. Management?
- Superficial strep infection
- Raised blisters around nose/mouth with honey-colored crust
- Antibacterial soap, topical/oral antibiotics, avoid contact with lesion
Carbuncles/Furnuncles
- Occur in areas with a lot of friction or perspiration (under shoulder pads, armpits)
- Look like boils with pus in them, almost like a pimple
- Another form of staph
- Furnuncle is one boil but if multiple come together they form a common purulent mass and that is a carbuncle
- Warm compress to bring to surface and professional can lance it (don’t have athlete pop it)
Folliculitis
- Whole bunch of bumps around areas of hair growth
- May be in areas that are shaved or taped often
- Less contagious but is form of staph
Guidelines to play for bacterial infections?
- Must complete 72 hour course of antibiotic therapy
- No drainage or exudate from wounds
- No new lesion for 48 hours
- Active lesions can’t be covered to allow participation
Categories of viral infections
- Herpes simplex
- Molluscum contagiosum
HSV
- HSV-1 (information below contains to this) and HSV-2 (genital)
- Incubation period for 3-10 days; prodromal symptoms = flu-like or burning
- Single vesicle or cluster (almost looks like a pimple size blister)
- Use antivirals (oral or cream)
- If on lip = herpes labialis; on body = herpes glatiatorum
Return to play for HSV
- Free of systemic symptoms
- No new lesions for 72 hours
- No moist lesions
- Minimum 5 days on systemic antiviral therapy
Molluscum Contagiousum
- Single vesicle or cluster
- Look similar to HSV but more fleshy colored/pink
- Can happen wherever
- May have flu-symptoms or burning
- You have to physically destroy the lesion (laser, cut it out, freeze)
Molluscum Contagiosum return to play
- Has to be curetted or removed
- Localized lesions can be covered with gas-permeable dressing followed by underwrap and stretch tape
Types of fungal infections
- Tinea capitus (head)
- Tinea corporus (body)
- Tinea cruris (groin)
- Tinea pedis (feet)
Tinea capitus
- Occurs on scalp
- Scaly patches and mild hair loss
- Topical antifungals
Tinea Corporus
- Ringworm
- Red, round, scaly patches on the skin
- Keep skin clean/dry
- Topical antifungal
- Wash anything that comes in contact with it
Tinea Pedis
- Usually in toe webs
- Topical antifungals (powders or creams)
How to manage open skin lesion?
- Clean
- Saline or portable tap water
- No scrubbing - Debridement
- Dependent on the wound
- If abrasion and turf on there, you need to irrigate/debride it
- If clean laceration you’re welcome to rinse it but don’t have to - Dressing
- Nonocclusive vs occlusive - Monitor/Treat
Nonocclusive vs occlusive dressing
- Nonocclusive
- Some sort of woven or non-woven gauze
- Non- adherent pad
- Used when we want air to get to this wound
- Puncture wound, wounds with cavities, some level of infection - Occlusive dressing
- Don’t want any air/moisture to come in
Contact Dermatitis
- Local inflammatory reaction to some offending agent
- Red, itchy, swollen, clearly demarcated
- Not contagious
- Avoid offending material
- If severe enough can use topical steroid or antihistamine
Acne Mechanica
- Looks like acne
- Friction/heat between skin and equipment
- Personal hygiene and moisture wicking clothes
Talon Noir
- Also called black heel
- Trauma induced/friction in footwear
- Dark lesion on fat pad
- Make sure things fit appropriately and see if they’re doing too much
Psoriasis
- Systemic inflammation, autoimmune
- Thick red skin with white patches anywhere on body (often in elbows and knees but can happen anywhere and often happens in flares)
- Not contagious
- Topical medications
Eczema
- Also, called atopic dermatitis
- Almost looks like a mix between abrasion and psoriasis (itchy and scaley)
- Usually environmental irritant but could be genetic
- Can be managed with topical steroid or moisturizer
Cholinergic Urticaria
- Sweat and heat
- Hives surrounded by redness caused by heat
- Cool the area and antihistamines
Types of scarring? Management?
Keloid = abdormal scarring beyond wound Barrie’s
Hypertrophic scarring = stays within the border but enlarged
Steroid injection, surgical removal, pressure dressing as developing (usually after surgical removal)
Pediculosis? Return to Play?
- Ectoparasite
- See burrows or tracks
- Louse (bug) or nit (eggs)
- Can easily be transmitted
- Medicated shampoos and lotions, thoroughly clean clothes/bed
You can return if you don’t have louse but if you have nits you can return (can be dead and located on body after treatment = medicated cream or shampoos).
Return to play requirements for the following:
1. Tinea capitis
2. Tinea corporis
3. HSV
4. Molluscum contagiosum
5. Impetigo
6. Folliculitis/furuncles/carbuncles
7. MRSA
- Minimum of 2 weeks of systemic antifungal therapy
- Topical fungicide for 72 hours and lesions covered with gas-permeable membrane
- HSV
- Free of systemic fever, malaise, etc
- No new blisters for 72 hours
- All lesions firm, adherent crust
- Completion of 5 days of systemic antiviral therapy
- Active lesions can’t just be covered to participate - Lesions curetted and covered with gas-permeable membrane
- All Bacterial Infections (5-7)
- No new lesion for 48 hours
- Completion of 72 hour antibiotic therapy
- No further drainage/exudate from wound
- Active infections can’t just be covered
What type of disinfectant should be used for routine cleaning?
Relatively unimportant, as long as it’s registered by EPA and manufacturer’s recommendations followed. Can use 1:10 ratio of household bleach to tap water for routine environmental disinfection.
How to clean sleeves, braces, and pads?
1:10 bleach/tap water solution every day.
Difference between psoriasis and eczema?
Psoriasis usually has white scaly portions, is less itchy, and is usually on the external surfaces of the body (not where the body folds). Eczema is more itchy, can be oozing and crusting, and is more often on the folds of the body. Psoriasis looks like more while scaly portions like outside of bread (thing sourdough sounds like psoriasis).
