ShawnaYoung, Ed.D. California State University, Stanislaus

Background Participation in combative activities (e.g., wrestling, self–defense, judo) can be a rewarding experience for students: an opportunity to acquire important skills for personal safety/self protection, and an opportunity for fitness development In some states, combative activities are a required curricular element Example: California requires inclusion of combative activity in high school physical education - mandated by the state education code.

Transmission of Skin Disease Combative activities can involve a significant amount of direct skin to skin contact where participants touch practice partners’ exposed skin on arms, legs, the neck, and face with his/her own exposed skin. If one practice partner is infected and contact is made, transmission may occur. If repeated contact with the mat by an individual infected with a skin disease and contact by another individual occurs, transmission may take place. It is important that physical educators & coaches take special care to manage the risk of transmission of communicable skin diseases.

Ringworm (Tinea)

What is it? Ringworm, also known as Tinea, is a fungus that infects the skin on its outer layers How is it Transmitted? Ringworm is transmitted by direct contact with an infected person or by the sharing of objects like clothes, towels, or sports equipment.

Ringworm (Tinea) Signs and symptoms Typically, ringworm results in an itchy rash that may form large round patches with a clearing in the center, giving it a ring-like appearance. Treatment When treated early, most cases are cured with topical antifungal creams. However, if they are not treated early enough, antibiotics may be required (Adams, 2002; Drake, 1996).

HSV-1 (Cold Sores)

What is it? Cold sores are blisters on the lip and outer edge of the mouth caused by the herpes simplex virus (which also causes genital herpes). Once the HSV is contracted, it remains in the body permanently and recurrent outbreaks may occur. How is it transmitted? HSV-1 is transmitted by direct skin contact with an infected person. It is important to know that transmission is not limited to contact between moist membranous areas such as the mouth and genitals. If there are breaks in the skin, for example on the finger, and that vulnerable area comes in contact with the herpes virus, transmission may occur.

HSV-1 (Cold Sores) Signs and symptoms Cold sores on the mouth can be painful and cause fever, a sore throat, and swollen lymph nodes in the neck. They appear as blisters that usually break open and weep clear fluid, then scab over and heal within a few days. However, if the infection spreads, more blisters may develop. Treatment There is no cure for cold sores or for the herpes virus. Once the virus is contracted, the individual is a permanent carrier. However, antiviral medications can reduce the symptoms associated with the outbreak of sores and may decrease the healing time (Marques & Straus, 2003; Sterling, 2002).

Impetigo

What is it? Impetigo is a bacterial skin infection that can appear anywhere on the body, typically on exposed skin areas. How is it transmitted? Impetigo is transmitted by direct skin contact with an infected person, or by the sharing of objects like infected clothes, towels, or sports equipment.

Impetigo Signs and symptoms The infected areas of the skin begin as blisters in small patches that break and expose moist red skin. The area then crusts over and gradually spreads. Treatment Mild cases can be treated with prescription ointments. More severe cases may require the use of antibiotics (Haines, 2005).

Staph Infection (Cellulitis)

What is it? Staph infection that involves skin is referred to as cellulitis, a bacterial infection that typically begins in the skin but can infiltrate deeper layers of tissue. How is it transmitted? Cellulitis is transmitted by direct skin contact with an infected person, or by the sharing of objects like infected clothing, towels, or sports equipment. It may begin at a break in the skin, but an opening in the skin is not necessary for infection to occur.

Staph Infection (Cellulitis) Signs and symptoms Staph cellulitis may begin as tender swollen warm red areas or sores. If allowed to progress, red streaks may radiate from the initial site of infection. Treatment Antibiotics are used to treat staph infection. However, if the infection is not treated early enough or the infection is resistant to the antibiotic used, the infection may penetrate deeper and affect muscle tissue and require surgery to clean the infection (Smith, 2005).

Prevention Do not allow a student to participate if he/she has any noticeable skin rash or sores. Sterilize the mat before each session. Make sure that any cuts or breaks in the skin are covered. Require students to shower with soap and water immediately following participation in a combative activity lesson. Require students to wash clothes used during a combative activity lesson and to wear clean clothes to every combative activity session.

REFERENCES Adams, B.B. (2002). Tinea corporis gladiatorum. Journal of American Academy of Dermatology, 47(2), California State Board of Education. (2005). Physical Education Model Content Standards for California Public Schools. Sacramento, CA: California State Board of Education. Drake, L.A. (1996). Guidelines of care for superficial mycotic infections of the skin: Tinea corporis, tinea cruris, tinea faciei, tinea manuum, and tinea pedis. Journal of American Academy of Dermatology, 34(2), Haines, C. (2005). Understanding impetigo – the basics. Retrieved June 10, 2005, from

REFERENCES Marques, A.R., & Straus, S.E. (2003). Herpes simplex. In I.M. Freedberg (Ed.), Fitzpatrick’s Dermatology in General Medicine (pp ). New York:McGraw Hill. Smith, M. (2005). Staph infection: Cellulitis. Retrieved June 10, 2005, from m m Sterling, J.C. (2002). Herpes simplex. In M.G. Lebwohl (Ed.), Treatment of Skin Diseases (pp ). London: Mosby International