Review Question - QID 3052

Figure D represents a MRSA pustule with erythematous base. The review article by Marcotte et al states that Community Acquired MRSA's virulence is due to resistance to methicillin and other ß-lactam antibiotics and presence of a cytotoxin that enhances tissue necrosis. The Level 4 study by Bach et al found a 73% incidence of community acquired MRSA in hand infections. NCAA rules for bacterial skin infections state players must go 48 hours without new lesions, have completed 72 hours of antibiotic therapy, and have no exudative lesions. Figure A represents impetigo and is also caused by Staphylococcus and is treated with Erythromycin and topical Mupirocin but does not require surgical intervention for larger lesions. Figure B represents Molluscum Contagiosum caused by a pox virus that creates a painless papule. NCAA rules state molluscum lesions need to be removed and covered with tegaderm prior to play. Figure C represents Tinea infection or ringworm caused by dermatophytes. NCAA rules state topical or oral antifungals are needed for 72 hours for skin lesions and 14 days for scalp lesions and lesions must be covered prior to return to competition. Figure E represents Herpes Gladiatorum often found on the face and body of contact athletes such as wrestlers. NCAA rules state athlete must have no new lesions over 72 hours, lesions must have a firm and adherent crust, absence of systemic symptoms, and antiviral therapy 120 hours prior to the competition.