Which skin infections are transmitted between athletes?
Myriad dermatoses can affect athletes. One of the most common cutaneous manifestations of athletic activity are skin infections caused by bacteria,1,2,3,4 viruses,1,2,4,5,6,7,8 and fungi.1,2,4,9,10,11 Many infections are contagious and may have serious ramifications for team practices and competitions. Knowledge of these infections facilitates implementation of rapid treatment and preventive measures to ensure the least disruption in daily team activities.
Several specific sports-related dermatologic conditions are caused by bacterial infection. Staphylococcal infection is the most common, but streptococcal infection is also common.1,2,3,4Both organisms may present as various clinical disorders, such as impetigo, erysipelas, folliculitis,1,2,4 and furunculosis.3 These infections are probably contagious. Impetigo, characterized by well-defined, erythematous, yellow-crusted, scaling plaques, and erysipelas, characterized by well-defined, advancing, erythematous plaques, can be treated with topical warm soaks and oral antibiotics.1,4 Folliculitis (figure 1) manifests as small follicular pustules that can be treated with topical or oral antibiotics.1 These bacterial infections occur in athletes participating in sports in which close personal contact occurs, including rugby, judo, and wrestling.2,4 Furunculosis outbreaks, however, have been noted also in football and basketball athletes. One study showed that 25% of high school athletes in these sports developed furunculosis.3 Direct contact with furuncles was significantly associated with transmission; exposure to equipment seemed to be less important in its transmission. Some authors, however, have suggested that athletic bags and wrestling mats may also facilitate transmission of organisms.4 Rapid treatment and isolation of the affected athlete from other competitors is important to decrease the rapid spread of the bacteria.1,2,4 Other authors have suggested that if the incidence of infection is low, bandaging may be a reasonable means to prevent transmission.3 If outbreaks continue within a team, the bacterial carrier status of the members can be evaluated by culturing crural areas and nasal passages,4 and appropriate treatment can be instituted.