Common Dermatologic Infections in Athletes and Return-to-Play Guidelines

Common Dermatologic Infections in Athletes and Return-to-Play Guidelines

Abstract

Although the usual perspective on return to play for athletes is recovery from injury, an unheralded aspect on return to play involves potentially contagious skin infections. An estimated 8.5% of health conditions and injuries related to high school sports and 21% of health conditions and injuries related to college sports involve infectious diseases of the skin. In about half of these cases, the head, face, or neck is affected. The infectious agents are common microorganisms, including methicillin-resistant and methicillin-sensitive Staphylococcus and Streptococcus bacteria, herpes viruses, and tinea fungi. The challenge for physicians is to provide proper treatment to patients within the return-to-play guidelines of a sport's governing body, resulting in rapid resolution of the condition, minimization of time spent out of the sport, and minimization of communicable spread of the disease.

Public participation in sports is popular in many countries, particularly the United States. Athletes often acquire dermatologic infectious diseases during their sporting activities. Direct and indirect transmission of infectious agents occurs readily by the shear nature of contact competition in the sports environment. Athletes commonly present to primary care physicians, sports medicine specialists, and dermatologists, but they may also present to any specialty provider. 
Preventing disruption of sports participation and achieving an appropriately timed return to play is challenging for both provider and patient. Poorly managed infectious disease may result in detrimental consequences to the patient's health and sports success. Furthermore, inaccurate diagnosis may lead to regional epidemics and other medical consequences, as well as substantial amounts of missed time from sports. Unnecessary missed time can result in increased morbidity as well as decreased athletic opportunities for the patient.
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