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Skin ConditionsSkin Conditions
Functions of SkinFunctions of SkinProtection: Protection: – UVUV– InfectionInfection– Heat RegulationHeat Regulation– InjuryInjury– Fluid/Electrolytes Loss Fluid/Electrolytes Loss
Due to tight packing of cells in upper epidermisDue to tight packing of cells in upper epidermisAlso helps avoid absorption of excessive environmental Also helps avoid absorption of excessive environmental fluids (i.e. swimming)fluids (i.e. swimming)
SensationSensationEndocrine:Endocrine:– Helps produce Vitamin DHelps produce Vitamin D
BlistersBlistersLeave blister intact as long as possibleLeave blister intact as long as possible– Protection and infectionProtection and infection
If removal is necessary, clean skin and If removal is necessary, clean skin and sharp object thoroughly sharp object thoroughly – Leave top layer of blister for protection, if Leave top layer of blister for protection, if
possiblepossible
Cover and pad with donut, if necessaryCover and pad with donut, if necessary
Keep clean and check for signs of Keep clean and check for signs of infection!infection!
Ingrown ToenailIngrown ToenailPainful conditionPainful conditionNail grows into lateral nail foldNail grows into lateral nail foldCaused by:Caused by:– Poorly fitting shoesPoorly fitting shoes– Improper nail trimmingImproper nail trimming– TraumaTrauma
Treatment:Treatment:– Soak in warm water and epson salt or betadineSoak in warm water and epson salt or betadine– Place cotton under nail to lift nailPlace cotton under nail to lift nail– Cut ‘V’ in the middle of the nail Cut ‘V’ in the middle of the nail – Surgery???Surgery???
Prevention: Prevention: – Keep nail trimmed straight across (not too long, not too Keep nail trimmed straight across (not too long, not too
short)short)
Contused NailContused Nail
Pressure and pain under nailPressure and pain under nail
May need to “drill” to relieve pressureMay need to “drill” to relieve pressure– Needle, sharp knife, or small drill bitNeedle, sharp knife, or small drill bit– Make sure surface and device are cleanedMake sure surface and device are cleaned– Go slowly so you don’t hit the nail bedGo slowly so you don’t hit the nail bed
Don’t allow athlete to rip Don’t allow athlete to rip
off nail, it may not grow back!off nail, it may not grow back!
ImpetigoImpetigoBacterial skin infection caused by strep or staphBacterial skin infection caused by strep or staphCan occur anywhere…most common around Can occur anywhere…most common around nose/mouthnose/mouthContagious & spread through close contact or Contagious & spread through close contact or sharing towels/clothing/etcsharing towels/clothing/etcTreated w/ antibiotics (oral or topical) ~3-7daysTreated w/ antibiotics (oral or topical) ~3-7daysSigns/Symptoms:Signs/Symptoms:– Red sores Red sores – Ooze fluidOoze fluid– Yellow-brown crustYellow-brown crust– Can be itchyCan be itchy
EczemaEczema
Inflammatory skin disease with red, itchy Inflammatory skin disease with red, itchy skinskin
FolliculitisFolliculitis
Infection in the hair follicle Infection in the hair follicle Most common on face/scalp & areas rubbed by Most common on face/scalp & areas rubbed by clothing, such as the thighs & groinclothing, such as the thighs & groinUsually caused by bacteriaUsually caused by bacteriaCan occur from damage caused by shaving or Can occur from damage caused by shaving or wearing clothes that rub the skin OR when wearing clothes that rub the skin OR when blocked or irritated (sweat, oil, makeup)blocked or irritated (sweat, oil, makeup)Self limiting w/ proper cleansingSelf limiting w/ proper cleansingSigns/Symptoms:Signs/Symptoms:– ““Red pimples” w/ a hair in the centerRed pimples” w/ a hair in the center– May drain pus, blood or both May drain pus, blood or both – May itch or burnMay itch or burn
Tetanus Infection (Lock Jaw)Tetanus Infection (Lock Jaw)Caused by Clostridium bacteriaCaused by Clostridium bacteriaBacteria live in soil, saliva, dust & enter body through Bacteria live in soil, saliva, dust & enter body through deep cut (i.e. stepping on nail) deep cut (i.e. stepping on nail) Causes painful tightening of the muscles, usually all Causes painful tightening of the muscles, usually all over the bodyover the body– It can lead to "locking" of the jawIt can lead to "locking" of the jaw– Impossible to open your mouth or swallowImpossible to open your mouth or swallow
Potentially life-threatening…requires immediate tx in Potentially life-threatening…requires immediate tx in hospital hospital Regular vaccines can prevent tetanusRegular vaccines can prevent tetanus– Children get shot as a part of their routine immunizationsChildren get shot as a part of their routine immunizations– Adults should get booster every 10 years and/or after a Adults should get booster every 10 years and/or after a
bad cut/burnbad cut/burn
RingwormRingwormTinea Corpus Tinea Corpus
Fungal infection of skinFungal infection of skin
Characterized by round patches w/ scaly raised Characterized by round patches w/ scaly raised boarder & central healing zoneboarder & central healing zone
Refer for correct Dx & appropriate Tx:Refer for correct Dx & appropriate Tx:– OTC: Lamisil, Lotrimin, TinactinOTC: Lamisil, Lotrimin, Tinactin
CANNOT participate in wrestling unless cleared & CANNOT participate in wrestling unless cleared & under treatment for 72hrsunder treatment for 72hrs
DO NOT just coverDO NOT just cover
Keep mats and body cleanKeep mats and body clean
Athletes FootAthletes FootTinea PedisTinea Pedis
Fungal infection of the foot Fungal infection of the foot
Sx’s: Sx’s: – Red scaly rashRed scaly rash– Peeling or cracking skinPeeling or cracking skin– BurningBurning– ItchingItching
Keep feet dry/clean!Keep feet dry/clean!
Tx: Tx: – OTC:OTC: Lamisil, Lotrimin, Tinactin Lamisil, Lotrimin, Tinactin
Jock ItchJock ItchTinea CrurisTinea Cruris
Sx’s:Sx’s: – Burning/ItchingBurning/Itching– Red, scaly patches of skinRed, scaly patches of skin
Keep area dry/cleanKeep area dry/clean
Tx:Tx:– OTC:OTC: Lamisil, Lamisil,
Lotrimin, TinactinLotrimin, Tinactin
Herpes Simplex -Herpes Simplex -(Cold Sores/Fever Blisters)(Cold Sores/Fever Blisters)
Type 1: Oral Herpes - causes sores around mouth/lips – Transmitted via oral secretions or sores on skin
Kissing or sharing toothbrushes/eating utensils
– Causes painful blisters– No cure - Remains in body & lies inactive in
nerve cells until triggered by:Sun exposure, fever, fatigue, stress
– Drugs can lessen severity
Type 2: Genital Herpes– Sexually transmitted
WartsWartsCaused by HPVCaused by HPVGeneral Tx: General Tx: – Salicylic Acid, Duck Tape, Liquid NitrogenSalicylic Acid, Duck Tape, Liquid Nitrogen
Common Wart:Common Wart:– Small, round elevated lesionSmall, round elevated lesion– Rough, dry surfaceRough, dry surface– Usually go away on their own within 18-24moUsually go away on their own within 18-24mo
Plantar Wart:Plantar Wart:– Found on bottom of footFound on bottom of foot– PainfulPainful– Wear sandals in Wear sandals in locker rooms/community showerslocker rooms/community showers
Cold Sensitivity/ReactionCold Sensitivity/Reaction
Cold Urticaria Cold Urticaria - Allergic Reaction w/ Hives- Allergic Reaction w/ Hives– Can be life-threateningCan be life-threatening– Redness, hives & itchingRedness, hives & itching– Can affect some areas and not othersCan affect some areas and not others
Can be hypersensitive without allergyCan be hypersensitive without allergy– Redness & painRedness & pain
Poison Oak/Ivy/SumacPoison Oak/Ivy/SumacCauses: Causes: – Direct contact with plantDirect contact with plant– Inhalation or skin exposure to airborne oil particles of Inhalation or skin exposure to airborne oil particles of
burning plantburning plant– Contact with contaminated materialsContact with contaminated materials
Sx’s:Sx’s: Within 12-48 hrs Within 12-48 hrs– Burning, itching, redness, rash, swelling blisters, high Burning, itching, redness, rash, swelling blisters, high
feverfever
Avoid scratching, ice, cold water?Avoid scratching, ice, cold water?
Cannot play with signs of serious infectionCannot play with signs of serious infection
May need to be cleared by physician for May need to be cleared by physician for wrestlingwrestling
Poison IvyPoison Ivy
Poison Oak/SumacPoison Oak/Sumac
Methicillin-resistant Methicillin-resistant Staphylococcus aureasStaphylococcus aureas
What is MRSAWhat is MRSAStaph InfectionStaph Infection
Bacteria that is resistant to certain antibioticsBacteria that is resistant to certain antibiotics– Methicillin, Penicillin, & AmoxicillinMethicillin, Penicillin, & Amoxicillin
Became increasingly common in hospital Became increasingly common in hospital setting in 1970’ssetting in 1970’s
MRSA-CA MRSA-CA (Community Acquired): (Community Acquired): emerged in 1990’semerged in 1990’s
May cause more serious infections:May cause more serious infections:– BloodBlood– PneumoniaPneumonia
How bad is CA-MRSA?How bad is CA-MRSA?
Most are minor infections and can be treated Most are minor infections and can be treated with an antibiotic creamwith an antibiotic cream
Some may require treatment w/ oral antibioticsSome may require treatment w/ oral antibiotics
A small percentage can be LIFE A small percentage can be LIFE THREATENINGTHREATENING
All MRSA infections should be evaluated by a All MRSA infections should be evaluated by a healthcare providerhealthcare provider– If the condition worsens you need to seek If the condition worsens you need to seek
immediate treatmentimmediate treatment
Who Gets MRSAWho Gets MRSA
Heathcare workers: 1:3Heathcare workers: 1:3
College & HS athletesCollege & HS athletes
InmatesInmates
Military recruits Military recruits
Daycare kidsDaycare kids
People in crowded conditionsPeople in crowded conditions
CA-MRSA BreakdownCA-MRSA Breakdown
Skin infectionsSkin infections 1,266 1,266 (77%)(77%)Wound (traumatic)Wound (traumatic) 157157 (10%)(10%)Urinary tract infectionUrinary tract infection 6464 (4%)(4%)SinusitisSinusitis 6161 (4%)(4%)BacteremiaBacteremia 4343 (3%)(3%)PneumoniaPneumonia 3131 (2%)(2%)
-Mostly skin infections-Mostly skin infections
MRSA Infections StatisticsMRSA Infections Statistics
Community
Healthcare
In 2007: In 2007: – 86% Healthcare Associated86% Healthcare Associated– 14% Community Associated14% Community Associated
In 2005: 94,350 serious infectionsIn 2005: 94,350 serious infections– ~18,650 people died ~18,650 people died – Mostly older Mostly older
persons (>65 y/o)persons (>65 y/o)
How is MRSA SpreadHow is MRSA SpreadBacteria is commonly carried on the skin Bacteria is commonly carried on the skin or in the nose of healthy individualsor in the nose of healthy individuals– 25% to 30% of the population are “colonized”25% to 30% of the population are “colonized”
Skin to skin contactSkin to skin contactCrowed living conditionsCrowed living conditionsSkin openings (cuts/abrasions)Skin openings (cuts/abrasions)Infected items (sports gear and clothing)Infected items (sports gear and clothing)Contaminated surfaces (weight room Contaminated surfaces (weight room equipment)equipment)Poor hygienePoor hygiene
What does MRSA look like?What does MRSA look like?
Skin can be: Skin can be: – Red or swollenRed or swollen– PainfulPainful– Pus or other drainagePus or other drainage
MRSAMRSA can live for months on MRSA can live for months on surfaces and fabrics:surfaces and fabrics: – Up to 7 months on dustUp to 7 months on dust– Up to 8 weeks on a mop headUp to 8 weeks on a mop head– Up to 9 weeks on cotton (towel)Up to 9 weeks on cotton (towel)– Up to 203 days (over 6 months) on a Up to 203 days (over 6 months) on a
blanketblanket
– MRSA can live on the skin of otherwise MRSA can live on the skin of otherwise healthy individuals, with no symptoms healthy individuals, with no symptoms indefinitely indefinitely
How do I prevent MRSA?How do I prevent MRSA?
Wash your handsWash your hands
Don’t share gear/clothingDon’t share gear/clothing
Clean sports gear oftenClean sports gear often
Tell ATC about skin woundsTell ATC about skin wounds
Keep cuts clean and coveredKeep cuts clean and covered
Don’t touch someone else’s Don’t touch someone else’s wounds/bandageswounds/bandages
Use a moisturizer to prevent cracking if the Use a moisturizer to prevent cracking if the skin is dryskin is dry
Athlete’s With MRSAAthlete’s With MRSAWound should be completely covered Wound should be completely covered – Cannot participate if the wound drainage cannot Cannot participate if the wound drainage cannot
be containedbe contained
Do not share equipment/clothing/towelsDo not share equipment/clothing/towels
Clean off equipment after useClean off equipment after use
If athlete is unable to maintain good personal If athlete is unable to maintain good personal hygiene, they should be removed from hygiene, they should be removed from participation until the infection clearsparticipation until the infection clears