Sports Dermatology: Part 1 of 2 Traumatic or Mechanical Injuries, Inflammatory Conditions, and Exacerbations of Pre-existing Conditions

Abstract

Competitive athletes endure extreme bodily stress when participating in sports-related activities. An athlete's skin is particularly susceptible to a wide array of repetitive physical and environmental stressors that challenge the skin's protective function. Many unique dermatoses are well-known to the serious athlete due to countless hours of intense physical training, but are frequently unrecognized by many healthcare professionals. Sports dermatology is a distinctive, budding field of dermatology that focuses on dermatoses frequently encountered in athletes. Athletic skin problems are notoriously infectious in nature due to the inherent environment of close-contact physical activity. Nonetheless, other skin conditions can manifest or worsen with recurring mechanical or traumatic injury or exposure to environmental hazards. Additionally, sports-related activities may exacerbate other pre-existing dermatological conditions that may possibly be unknown to the athlete or clinician. The objective of this two-part review is to arm the astute physician with the fundamental knowledge of the range of dermatological conditions distinct to the competitive athlete. Knowledge of these cutaneous conditions in the context of specific sporting events will permit the clinician to manage these unique patients most effectively. Part one will focus on traumatic or mechanical injuries, inflammatory conditions, and exacerbations of pre-existing conditions frequently seen in athletes.

Figure 1.

Friction blister. Discrete bullae formation at the site of irritation in an athlete with poorly fitted shoes

Figure 2.

Callus. Hyperkeratotic or thickened, asymptomatic plaque of the big toe

Figure 3.

Knuckle pads. Asymptomatic, well-circumscribed, smooth, firm, skin-colored papules and plaques over the dorsal aspects of the foot

Figure 4.

Piezogenic papules. Asymptomatic, compressible, skin-colored to yellow papules of the posterior heel as a result of increased heel pressure from sporting activities

Figure 5.

Talon noir. Asymptomatic, trauma-induced, dark plaque of the heel that occurs predominantly in young adult athletes and clinically resembles malignant melanoma

Figure 6.

Digital hemorrhage. Black discoloration secondary to trauma representative of hemorrhage on the index finger of a patient that clinically resembles malignant melanoma

Figure 7.

Erythema ab igne. Reticulated, hyperpigmented patches over the trunk secondary to exposure of an external heating source (a heating pad)

Figure 8.

Contact dermatitis. Localized, well-demarcated, erythematous, lichenified plaques over the dorsal aspect of the bilateral feet in a patient with contact allergy to shoe antigen components

Figure 9.

Cholinergic urticaria. Itching and burning preceding the onset of numerous small wheals with large surrounding flares on the torso of a patient

Figure 10.

Intertrigo. Erythema and weeping that progressed to maceration and crusting with secondary infection in an abdominal fold