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

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

11. Impetigo Honey colored Honey colored Wet, moist lesions Wet, moist lesions

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

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

14. Impetigo

15. Impetigo

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

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

18. Molluscum Contagiosum

20. Molluscum Contagiousum

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

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

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

24. Herpes Gladiatorum

27. Herpes vs Impetigo Herpes: multiple areas of vesicles, large lymph nodes, low grade fever, usually dominant side of wrestler 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 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 http://www.nlm.nih.gov/medlineplus/ ency/article/001439.htm http://www.nlm.nih.gov/medlineplus/ ency/article/001439.htm http://www.nlm.nih.gov/medlineplus/ ency/article/001439.htm http://www.webmd.com/skin- problems-and- treatments/tc/ringworm-of-the-skin- prevention http://www.webmd.com/skin- problems-and- treatments/tc/ringworm-of-the-skin- prevention http://www.webmd.com/skin- problems-and- treatments/tc/ringworm-of-the-skin- prevention http://www.webmd.com/skin- problems-and- treatments/tc/ringworm-of-the-skin- prevention http://dermatology.about.com/cs/fun galinfections/a/ringworm.htm http://dermatology.about.com/cs/fun galinfections/a/ringworm.htm

30. References http://www.emedicine.com/EMERG/to pic246.htm http://www.emedicine.com/EMERG/to pic246.htm http://www.emedicine.com/EMERG/to pic246.htm http://www.emedicine.com/EMERG/to pic246.htm http://dermnetnz.org/viral/herpes- simplex.html http://dermnetnz.org/viral/herpes- simplex.html http://dermnetnz.org/viral/herpes- simplex.html http://dermnetnz.org/viral/herpes- simplex.html http://dermnetnz.org/viral/herpes- zoster.html http://dermnetnz.org/viral/herpes- zoster.html

31. References http://www.nlm.nih.gov/medlineplus/e ncy/article/000860.htm http://www.nlm.nih.gov/medlineplus/e ncy/article/000860.htm http://www.nlm.nih.gov/medlineplus/e ncy/article/000860.htm http://www.nlm.nih.gov/medlineplus/e ncy/article/000860.htm http://www.webmd.com/a-to-z- guides/impetigo-overview http://www.webmd.com/a-to-z- guides/impetigo-overview http://www.webmd.com/a-to-z- guides/impetigo-overview http://www.webmd.com/a-to-z- guides/impetigo-overview