156 SECTION 3 • MEDICAL PROBLEMS IN THE ATHLETE
•Alternative equipment has been manufactured using
polyurethane, neoprene, and silicone to alleviate aller-
gic reactions.
- Antihistamines, corticosteroids, analgesics, and
H 2 -antagonists are commonly utilized for moderate to
severe systemic hypersensitivity reactions by either
oral or intravenous routes.
•Patch testing can often help identify the allergan trig-
gering the dermatitis.
ENVENOMATION
- Most of the allergic reactions are from hornets and
wasps (Frazier, 1977). - The venom can be neutralized with meat tenderizer or
shaving cream at the site. - Ice packs will reduce the swelling and slow the
absorption of the venom. - Antihistamines and nonsteroidal anti-inflammatory
agents are commonly prescribed.
•Participants with known allergic reactions to hym-
enoptera should be advised to use sunscreens with
insect repellent formulas. - Athletic trainers or physicians covering events should
always carry an Epi-Pen kit.
SWIMMER’S ITCH
•Parasitic dermatitis produced by the cercariae form of
the schistosomes commonly found in freshwater lakes
of the United States (Hoeffler, 1977).
- One- to two-millimeter macules develop into papules
on exposed areas, not under the bathing suit. - Acute symptomatic therapy with antihistamines and
topical steroids.
SEABATHER’S ERUPTION
- Pruritic, papules, and wheals primarily occur in scuba
divers off the East Coast of the United States from
Long Island, New York down into the Caribbean
(Freudenthal and Joseph, 1993). - Free-swimming, larval forms of Edwardsiella lineata
and Linuche unguiculata contain stinging nemato-
cysts (Freudenthal and Joseph, 1993). - Prolonged wearing of the bathing suit, washing off
with freshwater and strenuous exercise activate the
nematocysts (Freudenthal and Joseph, 1993).
•Meat tenderizer, baking soda, warm saltwater, vinegar
or shaving cream denature the nematocysts (Freuden-
thal and Barbagallo, 2002).
GREEN HAIR•Regular swimmers with natural or tinted blonde, gray
or white hair may develop a green tint to their hair
from the release of copper from pipes or algicides in
swimming pools (Basler et al, 2000).
•Immediately washing the hair and maintaining the
pool pH between 7.4 and 7.6 will prevent this condi-
tion (Pharis, Teller, and Wolf, Jr, 1997).
•Washing the hair with copper-chelating shampoos
(ultraswim) for 30 min or 3% hydrogen peroxide for
3 h will return the hair to its previous color (Basler,
1989).EXERCISED-INDUCED ANAPHYLAXIS- The most severe form of urticaria is exercised-induced
anaphylaxis (EIA) (Pharis, Teller, and Wolf, Jr, 1997). - Pruritus with large wheals may progress to systemic
symptoms of wheezing, nausea, diarrhea, angioedema,
hypotension, and shock. - Running has been found to be the most common exer-
cise predisposed to EIA (Adams, 2002a). - Three distinct patterns of cutaneous involvement
may be seen: cholinergic urticaria, giant urticaria,
and angioedema without urticaria (Lewis et al,
1981). - EIA lesions are large and are not produced by hot
showers, pyrexia, or anxiety. - Plasma histamine levels are elevated in all forms of
EIA. - Preventive measures include not exercising in
extremes of either hot or cold weather and the use of
nonsedating antihistamines 1 h prior to exercise
(Fisher, 1992). - Athletes who want to continue vigorous exercise
should be instructed to exercise with someone (jogging
partner) who has knowledge of their condition and
can administer an injectable subcutaneous 1:1000 epi-
nephrine syringe (EpiPen kit) (Bergfeld and Elston,
1994).
REFERENCES
Adams BB: Dermatologic disorders of the athlete. Sports Med
32:309, 2002a.
Adams BB: Tinea corporis gladiatorum. J Am Acad Dermatol
47:286, 2002b.
Basler RSW: Skin injuries in sports medicine. J Am Acad
Dermatol21:1257, 1989.