Crunch Time Decisions: Navigating Skin Issues in Athletes
The season is down to the final tournament. The team is playing well and the starting point guard is going to be returning after a significant ankle injury. You have worked everyday to resolve the swelling, range of motion and strength. The tournament draw is out and last year’s state champion is the team’s first opponent. Things are looking up after the ankle is declared fit to play.
All Eyes on You
Tuesday after practice a skin lesion appears on the point guard’s forearm. Initially it does not look like much so she ignores it throughout the week and over the weekend. She has had no ill contacts and feels well systemically, with no fever, nausea, headache or sore throat. She just wants it to go away. She describes that it itches. It is clearly getting larger.
You recall that there are specific rules regarding skin infections and return to play. Certain infections need to be treated for specific periods of time before clearance is granted, and the game is on Friday. What could it be? What treatment will give her the best chance to play Friday? Everyone is looking at you for the answer.
The Clock is Ticking…
A careful exam shows none of the redness or streaking that would be consistent with cellulitis. There is redness but it is clearly defined. There also appears to be several lesions. There is no discharge, drainage, or pockets of fluid that need draining. Could this be early MRSA? Or is it a fungal infection?
Call a Timeout and Make a Plan
You decide it is a fungal infection, ringworm. Treatment can start tonight with topical over-the-counter anti-fungal medicine. As long as there are no new lesions and no advancement of the infection, the rules in your association clear her to play on Friday with the lesions covered by an occlusive dressing. Crisis averted, the teams’ chances remain on the court rather than with your diagnosis.
Nothing but Net – The Team Moves On!
Skin lesions are a common problem in the athletic setting. They create a great deal of missed time from practice and competition for athletes. A grasp of the basics regarding common skin infections can help you navigate these situations and get your athletes back to activity faster. More importantly, you can direct athletes to appropriate care when the infections are of the more serious types. Some of these infections are potentially life altering and need treatment rapidly.
