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The article discusses the dermatologic complications of anabolic-androgenic steroid (AAS) abuse in athletes. It notes that such abuse is developed through cutaneous manifestations in the skin of an unaffected person. Furthermore, the occurrence of acne vulgaris is considered as one of the most common manifestations on the abuse of AASs. An overview on several associations between the use of AAS and cutaneous side effects is presented.

The article discusses the clinical presentation, prevention and treatment of tinea pedis, a fungal infection of the feet, to decrease the impact of this disease on athletes. The three clinical types of tinea pedis include interdigital, the most common form in toes webs, moccasin, and vesiculobullous. Several studies are cited to show the epidemiology of tinea pedis and its risk factors. Generally, medical treatments are needed, one of which is antifungal creams or powders for 4 weeks.

The article reports on the susceptibility of football athletes to many dermatological conditions compared to other athletes. The major skin problems include acne, contact/irritant dermatitis, athletes nodule and bacterial and viral infections among others. It concludes that the recognition, prevention and early treatment can decrease morbidity among athletes.

Evaluates the diagnostic value of the fluorescent anti-nuclear antibodies (ANA) test. Significance of the titer of a positive ANA test; Predictive value of the ANA test; ANA patterns associated with specific diseases; Specific antibodies and associated diseases.

A letter to the editor is presented regarding unilateral nevoid telangiectasia which is associated with elevated estrogen levels.

A letter to the editor is presented that discusses the cutaneous cryptococcosis in a patient on corticosteroid therapy for rheumatoid arthritis.

After completion of a marathon (26.2 mile running race), a 41-year-old woman presented to the medical tent complaining of hand swelling. She denied any hand pain or numbness, diarrhea, nausea, vomiting, or abdominal pain, but admitted to slight hoarseness. Whilst she denied shortness of breath at that moment, she had noted dyspnea out of proportion to her athletic activity during the first 3 miles of the marathon. Thereafter, she ran without respiratory discomfort. She also recalled hand swelling and dyspnea out of proportion to her activity during her marathon training, especially on warm and humid days. Similar lesions, but to a much milder degree, had developed during brisk walks. These lesions began within the first 15 min of exercise and were associated with pruritus. She admitted to eating, only occasionally, a banana before her runs. She denied developing lesions whilst experiencing sudden powerful emotions, taking hot showers, or eating hot foods. She had no other medical problems, except for depression, for which she took venlafaxine. The symptoms related to her running were unrelated to her venlafaxine intake. She began having the swelling many years before starting the medication and continued having the swelling after discontinuation of venlafaxine. She had no history of atopic dermatitis, but 2 years subsequent to this most recent episode, she had been diagnosed with atopic dermatitis by her primary medical physician. There was no family history of similar eruptions. Physical examination revealed diffuse swelling of both hands, including all digits, with mild, ill-defined overlying erythema (Fig. 1). She had similar lesions on her feet and also had mild diffuse facial swelling, but did not have pronounced lip, tongue, or eyelid swelling. The swelling largely resolved within 4 h. Exercise-induced anaphylaxis was diagnosed. The patient continues to have similar eruptions with exercise, but has refused treatment with antihistamines or epinephrine. [ABSTRACT FROM AUTHOR]

Knuckle pads, first described by Garrod in 1893, 1 are benign, asymptomatic, well- circumscribed, smooth, firm, skin colored papules, nodules, or plaques. They most commonly occur on the dorsal aspect of the proximal interphalangeal joint of the finger, 2 but also may occur on the dorsal aspects of the foot over joints. 3–5 Knuckle pads may be inherited or acquired. 1 While some authors suggest that trauma is not a significant factor, 6 acquired knuckle pads have been associated with repetitive friction and trauma, 2,7 and may resemble athlete's nodules (also referred to as collagenomas). 1 Histologically, knuckle pads are characterized by hyperkeratosis, hypergranulosis, proliferation of fibroblasts and capillaries, and thickened and irregular collagen bundles. 1 Few cases of knuckle pads involving the lower extremities have been reported. 7 Knuckle pads of the feet have been described in association with inherited syndromes, such as acrokeratoelastoidosis Costa, 3 a syndrome of knuckle pads, leukonychia and deafness, 4 and a syndrome of knuckle pads, leukonychia, deafness and keratosis palmoplantaris. 5 We report a case that illustrates an unusual presentation of acquired knuckle pads of the feet secondary to repetitive friction from athletic gear. [ABSTRACT FROM AUTHOR]

Biology professor Leo Buss often warned us that association did not imply causation. While some experienced with basic statistics would recognize that these words are not necessarily linked, this tenet may not be entirely clear to some dermatologists. Apart from confusing this issue of causal and noncausal associations, medical researchers often wantonly use the word association. The liberal use of the word association must be curtailed. Clearly the word association should not be abandoned. It aptly describes an important relationship between two disease states.

A letter to the editor on sports purpura is presented.

Background Eosinophilic folliculitis ( EF) comprises classic eosinophilic pustular folliculitis ( EPF), human immunodeficiency virus ( HIV)-related EF, and infantile EPF subtypes. A fourth proposed subtype describes EF associated with hematologic malignancy. Recently, EF has occurred after bone marrow or stem cell transplantation ( SCT). Objectives We report a unique case of EF after haploidentical allogeneic SCT for acute lymphoblastic leukemia ( ALL) and review the literature for similar cases. Methods A 56-year-old, HIV-negative ALL patient presented with an intensely pruritic papulopustular eruption. He had undergone haploidentical allogeneic SCT 65 days earlier, which he had tolerated well. Histopathology revealed a moderately dense perifollicular and perivascular lymphocytic infiltrate with many eosinophils extending from the superficial dermis to the subcutaneous fat. Fungal stains were negative. These findings were highly consistent with EF. Results Therapy with a class II topical corticosteroid ointment, oral doxepin, and emollients achieved near-resolution of the lesions within eight weeks. Transition to topical tacrolimus 0.1% ointment applied twice daily to residual lesions yielded complete clearance by 12 weeks with mild post-inflammatory hyperpigmentation. The patient's ALL remains in remission. Conclusions A fourth proposed subtype of EF is associated with HIV-negative hematologic disease. This subtype is distinguished by a predictable timeframe to presentation and a relatively rapid response to therapy. Although EF is an important consideration in all patients with hematologic malignancy, clinically heightened suspicion is warranted during the 2-3 months after transplant. [ABSTRACT FROM AUTHOR]

The third of this three-part series on water-related sports dermatoses discusses skin changes seen in athletes who participate in sporting activities on top of or nearby water. While also susceptible to several of the freshwater and saltwater dermatoses discussed in parts one and two of the series, these athletes may present with skin changes unique to their particular sports. This updated and comprehensive review details those near-water dermatologic conditions commonly seen in sailors, rowers, fishermen, surfers, windsurfers, rafters, and water skiers, and will serve as a guide for dermatologists, sports medicine physicians and other medical practitioners in recognition and treatment of these conditions. [ABSTRACT FROM AUTHOR]

The second part of this three-part series on water-related dermatoses will discuss dermatologic conditions seen in athletes exposed to saltwater. The vast majority of the following dermatoses result from contact with organisms that inhabit saltwater, including bacteria, cnidarians, and echinoderms. This review also will include other dermatoses affecting saltwater athletes and should serve as a guide for dermatologists, sports medicine physicians, and other medical practitioners in recognition and treatment of these dermatoses. [ABSTRACT FROM AUTHOR]

The first of this three-part series on water-related dermatoses involving the athlete will include sports occurring with the majority of time spent in the water. These sports include swimming, diving, scuba, snorkeling and water polo. Numerous authors have described dermatologic conditions commonly seen in swimmers. This series provides an updated and comprehensive review of these water dermatoses. In order to organize the vast number of skin conditions related to water exposure, we divided the skin conditions into groupings of infectious and organism-related dermatoses, irritant and allergic dermatoses and miscellaneous dermatoses. The vast majority of skin conditions involving the water athlete result from chemicals and microbes inhabiting each environment. When considering the effects of swimming on one’s skin, it is also useful to differentiate between exposure to freshwater (lakes, ponds and swimming pools) and exposure to saltwater. This review will serve as a guide for dermatologists, sports medicine physicians and other medical practitioners in recognition and treatment of these conditions. [ABSTRACT FROM AUTHOR]