Presenter: Dr. Adam Manis, University of Toronto
Differential Guide – Dr. A. Francella, Dr. N Dilworth, Dr. A Manis
Questions:
Resources:
Table 1: Summary of Athlete Skin Infections and Treatments
Infection Type | Appearance | Treatment |
Virus | ||
HSV (herpes gladitorium, herpes rugborium, scrumpox) | Groups of vesicles on erythematous base on head, face, neck, upper extremities | 1° infection= valcyclovir 1g po tid x 1wk2° infection = valcyclovir 500 mg po bid x 1 wk |
Molluscum contagiosum | Umbillicated pearly papules 1-10 mm diameter | Laser therapyCryotherapy |
Fungal | ||
Tinea corporis | Well-defined, erythematous, scaly lesions with raised borders (more irreg with herpes gladitorium) | Localized = clotrimazole 1% cream bid x 2-4 wks OR Ciclopirox 0.77% cream bid x 1 wk OR Terbinafine 1% cream bid x 2-4 wksExtensive skin involvement = consider systemitc treatment (see Tinea capitis) |
Tinea cruris (jock itch) | See Tinea corporis | |
Tinea pedis (Athlete’s foot) | Clotrimazole 1% cread od x 4-6wks OR Terbinafine 250 mg po od x 4 wks | |
Tinea capitis | Grey, scaly patches, +/- mild hair loss | Terbinafine 250 mg po od x 2-4 wks OR Ketaconazole 250 mg po od x 2-4 wks |
Bacterial | ||
Folliculitis | Multiple small erythematous papules < 5mm | Usually resolve spontaneously, warm compress |
Furuncle (boil) | Folliculitis extending deeper (into the dermis) | Usually resolve with warm compress, for large furuncles see tx of carbuncle/abscess |
Carbuncle/Abscess | Coalescence multiple folliculitii | I&DUse of concomitant antimicrobials controversial and should be considered on a case by case basis (if opted for and MSSA= dicloxacillin 500 mg po qid x 5-10d OR cephalexin 500 mg po qid x 5-10d, if MRSA = clindamycin 300-450 mg po tid x 5-10 d) |
Impetigo | Non-bullous; thin vesicles that rupture into honey-crusted lesions. Bullous: Raised blisters | Mupicorin 2% ointment bid x 1wk OR Fusidic acid 2% cream bid x 1wk |
* The listed therapeutic options are not extensive