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Erschienen in: Sports Medicine 6/2000

01.06.2000 | Injury Clinic

Tinea Gladiatorum

Wrestling’s Emerging Foe

verfasst von: Dr Thomas D. Kohl, Mary Lisney

Erschienen in: Sports Medicine | Ausgabe 6/2000

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Abstract

Tinea corporis, or ringworm, has become a common nuisance in competitive wrestling. Although it is a fairly benign infectious skin disease, it has significant effects on the ability of a wrestler to compete because of infection control issues. Very little has been published in the medical literature describing this problem. The majority of the literature has described outbreaks in an isolated group of wrestlers. One must examine ringworm infections in wrestlers as an entity distinct from tinea corporis infections typically seen in the paediatric population, thus the term ‘tinea gladiatorum’.
Tinea gladiatorum outbreaks have been caused by the dermatophyte, Trichophyton tonsurans. The epidemiology and microbiology point to person-to-person contact as the main source of transmission in wrestlers. The clinical features of tinea gladiatorum may or may not be consistent with those found in the general population. Ancillary tests, including potassium hydroxide preparations and fungal cultures may have to be done to confirm the diagnosis. Treatment guidelines for tinea corporis have failed to produce the desired goals in this particular population. More research studying different treatment regimens in the wrestling environment is needed to define the optimal treatment to return wrestlers to competition quickly without putting other wrestlers at risk for infection.
Intuitive hygiene practices have been suggested to prevent spread of the infection, but they have not been substantiated. Anecdotal reports suggest that hygiene practices fall short of producing adequate primary or secondary prevention. Pharmaceutical prophylaxis has been effective, but universal drug prophylaxis carries risks including drug adverse effects and potential drug resistance. The role of potential asymptomatic carriers of dermatophytes has yet to be elucidated in the origin and/or perpetuation of tinea gladiatorum outbreaks.
There are many unanswered questions about tinea gladiatorum. Sports medicine professionals must work to define this entity more completely before making recommendations about treatment, prevention and infection control. The ultimate goal is the eradication of tinea infections from the wrestling world. Energy should be focused on primary and secondary prevention, as well as treatment. Without a thorough knowledge of tinea gladiatorum as a distinct disease entity, wrestling has been losing its battle with this formidable opponent.
Literatur
2.
Zurück zum Zitat Beller M, Gessner BD. An outbreak of tinea corporis gladiatorum on a high school wrestling team. J Am Acad Dermatol 1994; 31 (2 Pt 1): 197–201PubMedCrossRef Beller M, Gessner BD. An outbreak of tinea corporis gladiatorum on a high school wrestling team. J Am Acad Dermatol 1994; 31 (2 Pt 1): 197–201PubMedCrossRef
3.
Zurück zum Zitat Stiller MJ, Klein WP, Dorman RI, et al. Tinea corporis gladiatorum: an epidemic of Trichophyton tonsurans in student wrestlers. J Am Acad Dermatol 1992; 27 (4): 632–3PubMedCrossRef Stiller MJ, Klein WP, Dorman RI, et al. Tinea corporis gladiatorum: an epidemic of Trichophyton tonsurans in student wrestlers. J Am Acad Dermatol 1992; 27 (4): 632–3PubMedCrossRef
4.
5.
Zurück zum Zitat Kohl TD, Martin D, Berger MS. Comparison of topical and oral treatment for tinea gladiatorum. Clin J Sport Med 1999; 9 (3): 161–6PubMedCrossRef Kohl TD, Martin D, Berger MS. Comparison of topical and oral treatment for tinea gladiatorum. Clin J Sport Med 1999; 9 (3): 161–6PubMedCrossRef
6.
Zurück zum Zitat Hradil E, Hersle K, Nordin P, et al. An epidemic of tinea corporis caused by Trichophyton tonsurans among wrestlers in Sweden. Acta Derm Venereol 1995; 75: 305–6PubMed Hradil E, Hersle K, Nordin P, et al. An epidemic of tinea corporis caused by Trichophyton tonsurans among wrestlers in Sweden. Acta Derm Venereol 1995; 75: 305–6PubMed
7.
Zurück zum Zitat Hazen PG, Weil ML. Itraconazole in the prevention and management of dermatophytosis in competitive wrestlers. J Am Acad Dermatol 1997; 36 (3 Pt 1): 481–2PubMedCrossRef Hazen PG, Weil ML. Itraconazole in the prevention and management of dermatophytosis in competitive wrestlers. J Am Acad Dermatol 1997; 36 (3 Pt 1): 481–2PubMedCrossRef
8.
Zurück zum Zitat Dienst WL, Dightman L, Dworkin MS, et al. Pinning down skin infections. Physician Sports Med 1997; 25 (12): 45–56 Dienst WL, Dightman L, Dworkin MS, et al. Pinning down skin infections. Physician Sports Med 1997; 25 (12): 45–56
9.
Zurück zum Zitat Odom R. Pathophysiology of dermatophyte infections. J Am Acad Dermatol 1993; 28 (5): S2–7CrossRef Odom R. Pathophysiology of dermatophyte infections. J Am Acad Dermatol 1993; 28 (5): S2–7CrossRef
10.
Zurück zum Zitat Frisk A, Heilborn H, Melon B. An epidemic of tinea corporis caused by Trichophyton tonsurans among wrestlers in Sweden. Acta Derm Venereol 1966; 46: 453–6PubMed Frisk A, Heilborn H, Melon B. An epidemic of tinea corporis caused by Trichophyton tonsurans among wrestlers in Sweden. Acta Derm Venereol 1966; 46: 453–6PubMed
11.
Zurück zum Zitat Kern ME, Blevins KS. Medical mycology: a self-instructional text. Philadelphia (PA): F.A. Davis Company, 1997 Kern ME, Blevins KS. Medical mycology: a self-instructional text. Philadelphia (PA): F.A. Davis Company, 1997
12.
Zurück zum Zitat Kemna ME, Elewski BE. A U.S. survey of superficial fungal diseases. J Am Acad Dermatol 1996; 35 (4): 539–42PubMedCrossRef Kemna ME, Elewski BE. A U.S. survey of superficial fungal diseases. J Am Acad Dermatol 1996; 35 (4): 539–42PubMedCrossRef
13.
Zurück zum Zitat Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandell GL, Douglas RG, Bennet JE, editors. Principles and practice of infectious diseases. 3rd ed. New York (NY): Churchill Livingstone, 1990: 2017–27 Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandell GL, Douglas RG, Bennet JE, editors. Principles and practice of infectious diseases. 3rd ed. New York (NY): Churchill Livingstone, 1990: 2017–27
14.
Zurück zum Zitat Knudsen EA. Experimental dermatophyte infection: the extent of fungal invasion. Acta Derm Venereol 1989; 69: 247–9PubMed Knudsen EA. Experimental dermatophyte infection: the extent of fungal invasion. Acta Derm Venereol 1989; 69: 247–9PubMed
15.
Zurück zum Zitat Hebert AA, Head ES, MacDonald EM. Tinea capitis caused by Trichophyton tonsurans. Pediatr Dermatol 1985; 2: 219–23PubMedCrossRef Hebert AA, Head ES, MacDonald EM. Tinea capitis caused by Trichophyton tonsurans. Pediatr Dermatol 1985; 2: 219–23PubMedCrossRef
16.
Zurück zum Zitat Cohn MS. Superficial fungal infections: topical and oral treatment of common types. Postgrad Med 1992; 91 (2): 239–44PubMed Cohn MS. Superficial fungal infections: topical and oral treatment of common types. Postgrad Med 1992; 91 (2): 239–44PubMed
17.
Zurück zum Zitat Bergus GR, Johnson JS. Superficial tinea infections. Am Fam Physician 1993; 48 (2): 259–68PubMed Bergus GR, Johnson JS. Superficial tinea infections. Am Fam Physician 1993; 48 (2): 259–68PubMed
18.
Zurück zum Zitat Haldane DJ, Robart E. A comparison of calcofluor white, potassium hydroxide, and culture in the laboratory diagnosis of superficial fungal infections. Diagn Microbiol Infect Dis 1990; 13: 337–9PubMedCrossRef Haldane DJ, Robart E. A comparison of calcofluor white, potassium hydroxide, and culture in the laboratory diagnosis of superficial fungal infections. Diagn Microbiol Infect Dis 1990; 13: 337–9PubMedCrossRef
19.
Zurück zum Zitat Drake LA, et al. Guidelines of care for superficial mycotic infections of the skin: tinea corporis, tinea faciei, tinea manuum, and tinea pedis. J Am Acad Dermatol 1996; 34: 282–6PubMedCrossRef Drake LA, et al. Guidelines of care for superficial mycotic infections of the skin: tinea corporis, tinea faciei, tinea manuum, and tinea pedis. J Am Acad Dermatol 1996; 34: 282–6PubMedCrossRef
20.
Zurück zum Zitat Fromtling RA. Overview of medically important antifungal azole derivatives. Clin Microbiol Rev 1988; 1: 187–217PubMed Fromtling RA. Overview of medically important antifungal azole derivatives. Clin Microbiol Rev 1988; 1: 187–217PubMed
21.
Zurück zum Zitat Smith EB. Topical antifungal drugs in the treatment of tinea pedis,tinea cruris, and tinea corporis. J Am Acad Dermatol 1993; 28: S24–8CrossRef Smith EB. Topical antifungal drugs in the treatment of tinea pedis,tinea cruris, and tinea corporis. J Am Acad Dermatol 1993; 28: S24–8CrossRef
22.
Zurück zum Zitat Gupta AK, Sander DN, Shear NH. Antifungal agents: an overview. Part II. J Am Acad Dermatol 1994; 30: 911–33PubMedCrossRef Gupta AK, Sander DN, Shear NH. Antifungal agents: an overview. Part II. J Am Acad Dermatol 1994; 30: 911–33PubMedCrossRef
23.
Zurück zum Zitat Friedlander SF. The evolving role of itraconazole, fluconazole, and terbenifine in the treatment of tinea capitis. Pediatr Infect Dis J 1999; 18 (2): 205–10PubMedCrossRef Friedlander SF. The evolving role of itraconazole, fluconazole, and terbenifine in the treatment of tinea capitis. Pediatr Infect Dis J 1999; 18 (2): 205–10PubMedCrossRef
24.
Zurück zum Zitat Cauwenbergh G, Degreef H, Heykants J, et al. Pharmacokinetic profile of orally administered itraconazole in human skin. J Am Acad Dermatol 1988; 18: 263–8PubMedCrossRef Cauwenbergh G, Degreef H, Heykants J, et al. Pharmacokinetic profile of orally administered itraconazole in human skin. J Am Acad Dermatol 1988; 18: 263–8PubMedCrossRef
25.
Zurück zum Zitat Willemsen M, DeDonecker P, Willems J, et al. Posttreatment itraconazole levels in the nail. J Am Acad Dermatol 1992; 26: 731–5PubMedCrossRef Willemsen M, DeDonecker P, Willems J, et al. Posttreatment itraconazole levels in the nail. J Am Acad Dermatol 1992; 26: 731–5PubMedCrossRef
26.
Zurück zum Zitat Faergemann J, Laufen H. Levels of fluconazole in serum, stratum corneum, epidermis-dermis (without stratum corneum) and eccrine sweat. Clin Exp Dermatol 1993; 18 (2): 102–6PubMedCrossRef Faergemann J, Laufen H. Levels of fluconazole in serum, stratum corneum, epidermis-dermis (without stratum corneum) and eccrine sweat. Clin Exp Dermatol 1993; 18 (2): 102–6PubMedCrossRef
27.
Zurück zum Zitat Haneke E. Fluconazole levels in human epidermis and blister fluid. Br J Dermatol 1990: 123: 273–7PubMedCrossRef Haneke E. Fluconazole levels in human epidermis and blister fluid. Br J Dermatol 1990: 123: 273–7PubMedCrossRef
28.
Zurück zum Zitat Faergemann J, Zehender H, Jones T, et al. Terbenifine levels in serum,stratum corneum, dermis-epidermis (without stratum corneum) and eccrine sweat. Acta Derm Venereol 1991; 71 (4): 322–6PubMed Faergemann J, Zehender H, Jones T, et al. Terbenifine levels in serum,stratum corneum, dermis-epidermis (without stratum corneum) and eccrine sweat. Acta Derm Venereol 1991; 71 (4): 322–6PubMed
29.
Zurück zum Zitat Bourland A, Lachapelle JM, Aussems J, et al. Double-blind comparison of itraconazole and griseofulvin in the treatment of tinea corporis and tinea cruris. Int J Dermatol 1989; 28: 410–2CrossRef Bourland A, Lachapelle JM, Aussems J, et al. Double-blind comparison of itraconazole and griseofulvin in the treatment of tinea corporis and tinea cruris. Int J Dermatol 1989; 28: 410–2CrossRef
30.
Zurück zum Zitat Hernanz ADP, Gomez SL, Lastra FG, et al. A comparative double-blind study of terbenifine and griseofulvin in tinea corporis and tinea cruris. Clin Exp Dermatol 1990; 15: 210–6CrossRef Hernanz ADP, Gomez SL, Lastra FG, et al. A comparative double-blind study of terbenifine and griseofulvin in tinea corporis and tinea cruris. Clin Exp Dermatol 1990; 15: 210–6CrossRef
31.
Zurück zum Zitat Roberts WO. Specific problems and pearls in wrestling. American College of Sports Medicine Team Physician II Course; 1999 Feb 24–28; San Antonio, 14 Roberts WO. Specific problems and pearls in wrestling. American College of Sports Medicine Team Physician II Course; 1999 Feb 24–28; San Antonio, 14
32.
Zurück zum Zitat Goodman RA, Thacker SB, Solomon SL, et al. Infectious disease in competitive sports. JAMA 1994; 271 (11): 862–7PubMedCrossRef Goodman RA, Thacker SB, Solomon SL, et al. Infectious disease in competitive sports. JAMA 1994; 271 (11): 862–7PubMedCrossRef
33.
Zurück zum Zitat Sevier TL. Infectious diseases in athletes. Med Clin North Am 1993; 78 (2): 389–412 Sevier TL. Infectious diseases in athletes. Med Clin North Am 1993; 78 (2): 389–412
34.
Zurück zum Zitat Scheinberg RS. Stopping skin assailants: fungi, yeasts, and viruses. Physician Sports Med 1994; 22: 33–9 Scheinberg RS. Stopping skin assailants: fungi, yeasts, and viruses. Physician Sports Med 1994; 22: 33–9
Metadaten
Titel
Tinea Gladiatorum
Wrestling’s Emerging Foe
verfasst von
Dr Thomas D. Kohl
Mary Lisney
Publikationsdatum
01.06.2000
Verlag
Springer International Publishing
Erschienen in
Sports Medicine / Ausgabe 6/2000
Print ISSN: 0112-1642
Elektronische ISSN: 1179-2035
DOI
https://doi.org/10.2165/00007256-200029060-00006

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