1. Common skin conditions in wrestling
Ringworm
Impetigo
Mulluscum Contagiosum
Herpes Gladiatorum

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

3. Ringworm (tinea corporis)
Raised circular patches at edges
Central portion is usually flat
Not from the mat surface
Skin to skin contact with infected individuals

4. Ringworm Care
Oral/topical treatment for 7days for skin lesions before wrestling
Covered with bioclusive plus pre-wrap and tape for extremities, may wrestle
Face and scalp may not have contact until lesion is flat????

5. Ringworm Care
Topical
Lamisil 1%, Mentax 1%, Naftin 1%, Spectazole 1% cream 2x per day
Continue treatment for 1 week after lesion is gone

6. Ringworm Care Oral medications Lamisil 250mgs per day for 2 weeks
Sporanox 200 mgs per day for 2 weeks
Diflucan 200 mgs once a week for 3 weeks

7. Ringworm appearance

8. Ringworm

9. Ringworm

10. Impetigo Bacterial infection (streptococcus or staphylococcus aureus)
Extremely contagious
May be spread on mat surface
Associated with minor skin trauma or secondary to viral infections

11. Impetigo
Honey colored
Wet, moist lesions

12. Impetigo Care Prescription Topical antibiotic: Mupirocin (Bactroban)
Oral antibiotic for 72 hours prior to contact
May not cover and wrestle
No oozing, draining or moist lesions

13. Impetigo Care Keflex 500 mgs 2x/day for 10 days
Pen VK 500 mgs 4x/day for 10 days
Clindamycin 300 mgs 4x/day for 10 days

14. Impetigo

15. Impetigo

16. Molluscum Contagiosum
Pox virus
Treat to prevent transmission
Central umblication, belly button appearance
Contact contagious

17. Molluscum Contagiosum Care
Must be curetted or removed before meet
Single or clustered lesions may be covered by Bioclusive then pre-wrap and tape

18. Molluscum Contagiosum

19. Molluscum Contagiosum

20. Molluscum Contagiousum

21. Herpes Gladiatorum Cold sores or recurrent “impetigo”
73% occur on head or face
3-8 days after contact
Only skin to skin , not from mats
Stress, cutting weight, abrasions may cause recurrence

22. Herpes Gladiatorum Care
No new and all lesions to be scabbed over
Must be on systemic antiviral for 148 hours(7 days) before practice or competition
If no meds: no visible lesions
No covering of lesions

23. Herpes Gladiatorum Single Outbreaks
Isolate the wrestler, seek medical care, no contact activities, antiviral for 6 days
All wrestlers in contact up to 3 days prior should be isolated for 8 days and monitored for symptoms.

24. Herpes Gladiatorum

25. Herpes Gladiatorum

26. Herpes Gladiatorum

27. Herpes vs Impetigo
Herpes: multiple areas of vesicles, large lymph nodes, low grade fever, usually dominant side of wrestler
Impetigo: large weeping areas, honey colored, no small vesicles, crustiness covering the sites

28. Herpes vs Impetigo

29. References http://www.nlm.nih.gov/medlineplus/ency/article/001439.htm

30. References http://www.emedicine.com/EMERG/topic246.htm

31. References http://www.nlm.nih.gov/medlineplus/ency/article/000860.htm