How To Identify And Treat Pruritic Conditions In Athletes

By Mark Caselli, DPM

Treating And Preventing Impetigo

   Treating impetigo involves the use of both topical and systemic antibiotics. Mupirocin 2% ointment is the most effective topical agent. One should clean the lesions with soap and water or peroxide before applying the ointment and a dry dressing. Multiple lesions often require oral antibiotics such as cefadroxil, cephalexin, dicloxacillin, amoxicillin/clavulanate or erythromycin. However, keep in mind that streptococcal species are showing increased resistance to erythromycin.    Prevention of impetigo is paramount in athletes. Cleanliness and proper treatment of superficial skin injuries is paramount. Other methods of prevention and thwarting the spread of impetigo include good personal hygiene, and meticulous cleaning of wrestling mats and other equipment with antiseptic agents. Due to the infectious nature of impetigo, the lesions should be clear of crusting before athletic participation is allowed.

How To Handle Erythrasma

   Three similarly presenting pruritic skin infections of the foot include erythrasma, tinea pedis and candidiasis. They are caused by either a bacterial, fungal or yeast-like fungal organism, respectively.    Erythrasma is a bacterial infection involving the toe web area. This condition is frequently confused with fungal and candidal infections. The invading organism is Corynebacterium minutissimum. Predisposing factors include humidity, hyperhydrosis, heat, obesity and poor foot hygiene. This condition usually involves the third and fourth toe web spaces. Painful longitudinal fissures may occur in advanced cases. Erythrasma differs from fungal infections in that it has no advancing borders, is uniformly reddish brown and scaly, and fluoresces bright coral-red with Wood’s light.    Treatment involves extensive washing of the involved area with antibacterial soap and thorough drying after each wash. Topical 2% erythromycin solution is curative when patients apply it daily. In severe cases, it may be necessary to prescribe oral erythromycin 1 gram daily for seven days.

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