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Sports Medicine Review – Dermatology Review

Dermatology Review

Presenter:  Dr. Adam Manis, University of Toronto

Differential Guide – Dr. A. Francella, Dr. N Dilworth, Dr. A Manis



Table 1:  Summary of Athlete Skin Infections and Treatments

Infection Type Appearance Treatment
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
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
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