Diagnosis of sports-related dermatoses

Health effects of exposure to chlorination by-products in swimming pools

Concerns have been raised regarding the potential negative effects on human health of water disinfectants used in swimming pools. Among the disinfection options, the approaches using chlorine-based products have been typically preferred. Chlorine readily reacts with natural organic matter that are introduced in the water mainly through the bathers, leading to the formation of potentially harmful chlorination by-products (CBPs). The formation of CBPs is of particular concern since some have been epidemiologically associated with the development of various clinical manifestations. The higher the concentration of volatile CBPs in the water, the higher their concentration in the air above the pool, and different routes of exposure to chemicals in swimming pools (water ingestion, skin absorption, and inhalation) contribute to the individual exposome. Some CBPs may affect the respiratory and skin health of those who stay indoor for long periods, such as swimming instructors, pool staff, and competitive swimmers. Whether those who use chlorinated pools as customers, particularly children, may also be affected has been a matter of debate. In this article, we discuss the current evidence regarding the health effects of both acute and chronic exposures in different populations (work-related exposures, intensive sports, and recreational attendance) and identify the main recommendations and unmet needs for research in this area.

Fractional Carbon Dioxide Laser Versus Carboxytherapy in Treatment of Striae Distensae

BACKGROUND AND OBJECTIVES

The aim of this study was to compare the efficacy and safety of fractional carbon dioxide (CO₂ ) laser versus carboxytherapy in treatment of striae distensae.

STUDY DESIGN/MATERIALS AND METHODS

This study was conducted on forty female patients with striae distensae on the abdomen. Patients were selected and divided randomly into two matched groups; group I was treated with fractional CO₂ laser resurfacing and group II with carboxytherapy. Assessment and evaluation of the results were done by comparing photographs and the Global Aesthetic Improvement Scale (GAIS).

RESULTS

Pregnancy, obesity, and long-term steroid use were the most common causes of striae in both groups. Both groups showed a statistically significant improvement in both the width and length of striae with no statistically significant difference between them. Patients' satisfaction was comparable in both groups. Pain and post-inflammatory hyperpigmentation were the two most common side effects in group I while bruising at the injection site was the most common in group II.

CONCLUSIONS

Both modalities could be effective in management of striae distensae. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.

Sports Dermatology: Skin Disease in Athletes

There are numerous disorders of the skin that occur in athletes. These include infections, mechanical injury, and inflammatory skin diseases such as dermatitis, urticaria, and others. This paper discusses some of the most common athletic skin diseases.

Evaluating and reducing xerosis in competitive swimmers: an in vitro study and randomized controlled clinical trial

INTRODUCTION

Xerosis is a common problem with significant sequelae in competitive swimmers, and it results from transepidermal water loss. This study evaluates moisture barriers for reducing xerosis in competitive swimmers.

METHODS

An artificial skin model was used to evaluate five products. Models were measured for changes in thickness and weight over 7 days. The optimal barrier was tested in a randomized controlled trial (RCT) of 20 swimmers. Skin moisture content was serially measured. Skin micrographs were scored in a blinded fashion.

RESULTS

The moisture barrier #1 treated skin model at day 7 maintained a mean thickness of 7.08 mm versus 2.38 mm for control (p = .0001). The mean weights of group 1 treated and control groups at day 7 were 40.1 and 8.65 g (p = .03). In the RCT, the group treated with moisture barrier #1 and the controls exhibited low moisture content and moderate xerosis scores at baseline. At week 3, moisture measurements for treated and control groups were 28.6% and 18.2% (p = .003). The mean xerosis scores for the treated and control groups were 8.5 and 12.9 (p = .0008).

CONCLUSIONS

Artificial skin preservation varied for five commercially available moisture barriers. Moisture barrier application improved moisture content and reduced xerosis in competitive swimmers.

Addressing skin abrasions on artificial turfs with zwitterionic polymer brushes

Zwitterionic polymer brushes were investigated for their skin-friendliness outside of the common aqueous environment, exhibiting superior lubrication and antifouling properties.

Sports-related dermatoses among road runners in Southern Brazil

BACKGROUND

Road running is a growing sport. OBJECTIVES: To determine the prevalence of sports-related dermatoses among road runners.

METHODS

Cross-sectional study of 76 road runners. Assessment was performed by means of a questionnaire, interview, and clinical examination. The chi-square and linear trend tests were used for analysis.

RESULTS

Most athletes were men (61%), aged 38±11 years, who ran mid- or long-distance courses (60.5%) for 45 to 60 minutes (79%), for a total of 25-64 km (42.1% ) or more than 65 km (18.4%) per week. The most prevalent injuries were blisters (50%), chafing (42.1%), calluses (34.2%), onychomadesis (31.5%), tinea pedis (18.4%), onychocryptosis (14.5%), and cheilitis simplex (14.5%). Among athletes running >64 km weekly, several conditions were significantly more frequent: calluses (p<0.04), jogger's nipple (p<0.004), cheilitis simplex (p<0.05), and tinea pedis (p<0.004). There was a significant association between the weekly running distance and the probability of skin lesions. Of the athletes in our sample, 57% trained before 10 a.m., 86% wore clothing and accessories for sun protection, 62% wore sunscreen, and 19.7% experienced sunburn. Traumatic and environmental dermatoses are common in practitioners of this outdoor sport, and are influenced by the weekly running distance.

CONCLUSION

In this group of athletes, rashes, blisters, sunburn, and nail disorders were recurrent complaints regardless of running distance. Calluses, athlete's foot, chapped lips, and jogger's nipple predominated in individuals who ran longer routes.

Lesões desportivas e cutâneas em adeptos de corrida de rua

INTRODUÇÃO: A corrida de rua é uma modalidade em expansão e tem sido utilizada como lazer, esporte ou prática competitiva.OBJETIVO: Verificar frequência de lesões desportivas e cutâneas em atletas de corrida de rua. Material eMÉTODOS: Estudo transversal de 220 atletas de corrida de rua com questionário e observação clínica. Análise pelos testes t, Mann-Whitney, Qui-quadrado e correlação de Spearman.RESULTADOS: Predominaram atletas do sexo masculino, adultos, praticantes de corrida de longa distância, que treinam em média 45 a 60 minutos com frequência de 2 e 3 vezes por semana e têm participação variável em competições. As principais lesões relatadas foram dor no joelho (30,4%), distensão/estiramento muscular (16,7%), tendinites (10,1%), dor nos quadris (7,3%) e dor na coluna (7%), sem diferenças estatísticas entre os gêneros. Houve associação significativa entre quilômetros percorridos em treino e lesões musculares nos homens (p = 0,0477, x = 9,60). O calçado esportivo teve relação com presença de unhas encravadas e perdas ungueais nas mulheres.CONCLUSÃO: Os homens apresentaram maior frequência de lesões musculares e as mulheres, de afecções cutâneas e ungueais.

Understanding the Acute Skin Injury Mechanism Caused by Player-Surface Contact During Soccer: A Survey and Systematic Review

Background:

Superficial skin injuries are considered minor, and their incidence is probably underestimated. Insight into the incidence and mechanism of acute skin injury can be helpful in developing suitable preventive measures and safer playing surfaces for soccer and other field sports.

Purpose:

To gain insight into the incidence and severity of skin injuries related to soccer and to describe the skin injury mechanism due to player-surface contact.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

The prevention model by van Mechelen et al (1992) combined with the injury causation model of Bahr and Krosshaug (2005) were used as a framework for the survey to describe the skin injury incidence and mechanism caused by player-surface contact.

Results:

The reviewed literature showed that common injury reporting methods are mainly based on time lost from participation or the need for medical attention. Because skin abrasions seldom lead to absence or medical attention, they are often not reported. When reported, the incidence of abrasion/laceration injuries varies from 0.8 to 6.1 injuries per 1000 player-hours. Wound assessment techniques such as the Skin Damage Area and Severity Index can be a valuable tool to obtain a more accurate estimation of the incidence and severity of acute skin injuries.

Conclusion:

The use of protective equipment, a skin lubricant, or wet surface conditions has a positive effect on preventing abrasion-type injuries from artificial turf surfaces. The literature also shows that essential biomechanical information of the sliding event is lacking, such as how energy is transferred to the area of contact. From a clinical and histological perspective, there are strong indications that a sliding-induced skin lesion is caused by mechanical rather than thermal injury to the skin.

Skin conditions in the athlete

Dermatologic conditions are a common presenting complaint in the athletic training room. There are many different causes for rashes, and treatment options vary depending on the condition and the severity. Bacterial infections of the skin have a variety of different appearances and can spread rapidly among individuals. Healthcare providers need to be aware of the increasing prevalence of methicillin-resistant Staphylococcus aureus when making the choice of antibiotics. Other infectious rashes, including tinea and herpes, are well-described conditions in wrestlers; however, these rashes can be seen in any athlete, especially those engaged in contact sports. Early recognition and appropriate treatment are important to clear the rash and reduce the spread to others. In addition to infectious rashes, athletes are prone to mechanical rashes and skin conditions due to friction and tight-fitting equipment. Sports medicine providers must not only diagnose and treat these conditions but also be aware of the return-to-play guidelines set forth by the governing bodies under which he or she operates.

Training Room Management of Medical Conditions: Sports Dermatology

Athletes' skin is subject to a distinct array of physical and environmental stressors. Trauma, the elements, and pathogenic organisms constantly challenge the skin's integrity. This article intends to arm the clinician with a fundamental knowledge of infections, mechanical injuries, and environmental insults common to the skin of athletes. Photographs corresponding to the described entities are included as figures. Because rapid return to play is the ultimate goal after injury or illness, there is a section dedicated to play restrictions as set forth by the National Collegiate Athletic Association. Although the evaluation and management of cutaneous disease is a challenging endeavor, a consistent and systematic approach to this most accessible organ can result in early diagnosis, appropriate treatment, and ultimate performance.