Broken Nails to Blistered Heels

Toenail injuries, blisters, calluses, corns and plantar warts frequently cause disability among active people at all levels of training or competition. Simple office procedures, such as making a toenail protection shell or treating a blister, can minimize the patient's time away from his or her sport. Giving athletes tips on proper footwear can often help prevent these painful conditions.     

A Guide to Blister Management

Friction blisters are a common annoyance for virtually all active patients at every level—from weekend warriors to professional athletes. Whereas small friction blisters are usually self-limited and amenable to conservative treatment, larger ones generally respond better when they are first aseptically drained. Proper care of the blister site will ward off infection, a possible complication of both spontaneous rupture and therapeutic draining. Properly fitted shoes, socks, and athletic equipment, together with the judicious use of lubricants, can help prevent the formation of friction blisters.     

Stepping Into the Right Sock

Dressing feet is not as simple as it once was. Hundreds of types of socks—including socks for specific sports—are now available for athletic consumers. When counseling athletes dazzled by the array of options, physicians can recommend emphasizing the basics: Socks and shoes need to fit together well. Careful sock selection also can help relieve foot conditions and prevent painful blisters.     

Injuries associated with strenuous road marching.

Injuries were recorded during and up to 12 days after a maximal effort road march. Light infantry soldiers (N = 335) carried a total load of 46 kg over a 20 km course. Twenty-four percent of the soldiers suffered one or more injuries, resulting in 44 days of limited duty. All injuries involved the lower extremities and/or the back. Foot blisters and back problems were the most common complaints (35% and 23%, respectively, of the total injuries). These data indicate that units without recent road marching training can expect a high incidence of injuries as a result of a single demanding road march.     

Initial subjective load carriage injury data collected with interviews and questionnaires

This study aimed to identify the types, incidence, and causes of any potential load carriage injuries or discomfort as a result of a 2-hour, forced-speed, treadmill march carrying 20 kg. Subjective load carriage data were collected, through both interviews and questionnaires, from relatively inexperienced soldiers after a period of load carriage. Results from the study showed that the upper limb is very susceptible to short-term discomfort, whereas the lower limb is not. The shoulders were rated significantly more uncomfortable then any other region, and blisters were experienced by approximately 60% of participants. Shoulder discomfort commences almost as soon as the load is added and increases steadily with time; however, foot discomfort increases more rapidly once the discomfort materializes. In conclusion, early development of shoulder pain or blisters may be a risk factor for severe pain or noncompletion of a period of prolonged load carriage.     

淋巴瘤样丘疹病1例并文献复习

目的：探讨淋巴瘤样丘疹病的病因、诊断和鉴别诊断、治疗及预后,以提高对该病的认识。方法对1例C型淋巴瘤样丘疹病的临床资料、组织病理、免疫荧光进行分析,并对相关文献进行分析。结果患者全身反复红斑、丘疹、水疱、结痂伴痒1个月余。皮肤科检查：躯干、四肢可见弥漫分布的米粒至黄豆大小的红斑、丘疹、水疱,部分皮损可见坏死、结痂。阴囊及阴茎部皮肤可见黄豆至钱币大小溃疡。全身未见明显脓疱,各关节及指趾甲未见明显异常。皮肤组织病理检查：表皮变性坏死,表皮下水疱形成,真皮内血管扩张,管壁纤维素样变性,血管周围见明显炎性细胞浸润,可见明显异型细胞及核丝分裂。免疫荧光检查：IgG (－)、IgM (－)、IgA (－)、C3(－)。抗酸染色阴性。免疫组化检查：真皮内浸润细胞表达CD3(+)、CD4(－)、CD8(+)、CD20(－)、CD30(+)、CD56(－)、Ki67(+＞50%)。T淋巴瘤克隆性基因重排（+）。诊断：C型淋巴瘤。结论淋巴瘤样丘疹病（lymphoma papulosis,LyP）是一种慢性复发性、自愈性皮肤丘疹、坏死、结节,临床结果良性、但组织病理上呈恶性表现的惰性皮肤淋巴瘤,属于皮肤CD30（+）淋巴增殖性疾病。其确切的发病机制还不清楚。治疗只能缓解症状,而不能阻止疾病的转归,目前还缺乏有效预防继发淋巴瘤的治疗方法,需长期随访监测并治疗继发性淋巴瘤。     

Postmortale Differentialdiagnose und forensische Relevanz kutaner Blasenbildungen

Cutaneous blisters on a corpse are not only of forensic interest regarding their etiology and genesis but also the time of origin, particularly the problem of vital, agonal, supravital or postmortem occurrence of cutaneous blisters could be of forensic value. The aim of this work was to summarize the causative spectrum of cutaneous blisters, including poisonous plants and animals, drugs and toxic substances. The time of origin of cutaneous blisters were evaluated in selected forensically relevant cases.     

Common injuries among Nigerian games players

The study investigated the common types and sites of injuries which were sustained by male soccer, basketball and field hockey players during a period of 8 weeks of intensive training and competition. In all, 170 soccer players, 127 basketball players and 212 hockey players drawn from various clubs in Nigeria formed the subjects of the study, a total of 509 patients.

Questionnaires on the prospective injury experience were handed over to the club members. A total of 630, 308 and 641 injuries were recorded in soccer, basketball and hockey respectively. In soccer the common injuries were sprains and strains (45.6%), bruises and cuts (27.0%) and concussion (15.2%). The lower limb had the highest number of injuries (49.1%).

In basketball common injuries were sprains and strains (41.5%), bruises and cuts (26.7%) and swelling and blisters (22.1%). The most common site of injury was the upper limb which sustained 45.8% of the injuries.

The common injuries in hockey were bruises and cuts (50.8%), swelling and blisters (21.5%) and sprains and strains (20.2%). The lower limb sustained the highest number of injuries (57.5%).

     

Rowing Injuries

IN BRIEF: Rowing—whether on the water or with machines—is increasingly popular, and, as with any strenuous exercise, the potential for injury is high. Rowers may have common symptoms, such as low-back and knee pain, or more sport-specific problems such as rib stress fractures, nerve impingement, and blisters. Virtually all rowing injuries are due to overuse, and many can be traced to training errors or equipment problems. Understanding the mechanics of rowing, the equipment, and the training procedures is essential for the physician caring for injured rowers.     

Ⅱ度烧伤早期正规与非正规MEBT的对比研究

为了揭示Ⅱ度烧伤创早期应用正规ＭＥＴ的重要性及早期保留疱皮的临床意义。方法：选取Ⅰ度小烧伤创面，按就诊面情况分为正规ＭＥＢＴ与非正规ＭＥＢＴ两大组，非正规ＭＥＢＴ组中又分为疱皮完整与疱皮撕脱两小组，接诊后均用ＭＥＢＯ治疗创面，肉眼观察创面面愈合情况。     

Augmentation and replacement cystoplasty: sonographic findings

Sonographic evaluation of the urinary tract after bladder augmentation and replacement procedures often reveals unexpected findings that result from incorporation of bowel into the urinary bladder wall. Familiarity with such findings is important to avoid misinterpreting them as abnormalities. The authors reviewed the sonograms of 47 patients. The most common findings were thick or irregularly shaped bladder walls (96%), pseudomasses within the bladder lumen (89%), and fine debris or linear strands (47%). Pseudomasses were potentially the most confusing; they are usually attributable to normal bowel folds, intraluminal mucus collections, or segments of bowel that have been intussuscepted into the bladder to prevent reflux.     

Endoluminal treatment of aortic dissection

Aortic dissection is most often a catastrophic medical emergency which, if untreated, can be potentially fatal. The intention of therapy in patients with aortic dissection is to prevent aortic rupture or aneurysm formation as well as to relieve branch vessel ischaemia. Patients with aortic dissection are often poor candidates for anaesthesia and surgery and the surgical procedure itself is challenging requiring thoracotomy, aortic cross clamping, blood transfusion as well as prolonged hospital stay in some cases. Operative mortality is especially high in patients with critical mesenteric or renal ischaemia. The past decade has experienced the emergence of a number of interventional radiological or minimally invasive techniques which have significantly improved the management of patients with aortic dissection. These include stent grafting for entry site closure to prevent aneurysmatic widening of the false lumen as well as percutaneous techniques such as balloon fenestration of the intimal flap and aortic true lumen stenting to alleviate branch vessel ischaemia. False lumen thrombosis following entry closure with stent grafts has been observed in 86–100% of patients, whereas percutaneous interventions are able to effectively relieve organ ischaemia in approximately 90% of the cases. In the years to come, it is to be expected that these endoluminal techniques will become the method of choice for treating most type-B dissections and will assist in significantly reducing the number of open surgical procedures required for type-A dissections. The intention of this article is to provide an overview of the current status of these endoluminal techniques based on our own experience as well as on a review of the relevant literature.     

Dermatologic disorders of the athlete

The most common injuries afflicting the athlete affect the skin. The list of sports-related dermatoses is vast and includes infections, inflammatory conditions, traumatic entities, environmental encounters, and neoplasms. It is critical that the sports physician recognises common and uncommon skin disorders of the athlete. Knowledge of the treatment and prevention of various sports-related dermatoses results in prompt and appropriate care of the athlete. Infections probably cause the most disruption to individual and team activities. Herpes gladiatorum, tinea corporis gladiatorum, impetigo, and furunculosis are sometimes found in epidemic proportions in athletes. Vigilant surveillance and early treatment help teams avoid these epidemics. Fortunately, several recent studies suggest that pharmacotherapeutic prevention may be effective for some of these sports-related infections. Inflammatory cutaneous conditions may be banal or potentially life threatening as in the case of exercise-induced anaphylaxis. Athletes who develop exercise-induced anaphylaxis may prevent outbreaks by avoiding food before exercise and extreme temperatures while they exercise. Almost all sports enthusiasts are at risk of developing traumatic entities such as nail dystrophies, calluses and blisters. Other more unusual traumatic skin conditions, such as talon noire, jogger's nipples and mogul's palm, occur in specific sports. Several techniques and special clothing exist to help prevent traumatic skin conditions in athletes. Almost all athletes, to some degree, interact with the environment. Winter sport athletes may develop frostbite and swimmers in both fresh and saltwater may develop swimmer's itch or seabather's eruption, respectively. Swimmers with fair skin and light hair may also present with unusual green hair that results from the deposition of copper within the hair. Finally, athletes are at risk of developing both benign and malignant neoplasms. Hockey players, surfers, boxers and football players can develop athlete's nodules. Outdoor sports enthusiasts are at greater risk of developing melanoma and non-melanoma skin cancer. Athletes spend a great deal of time outdoors, typically during peak hours of ultraviolet exposure. The frequent use of sunscreens and protective clothing will decrease the athlete's sun exposure. It is critical that the sports physician recognises common and uncommon skin disorders of the athlete. Knowledge of the treatment and prevention of various sports-related dermatoses results in prompt and appropriate care of the athlete.     

Sideline skin and wound care for acute injuries

The management of acute skin trauma in sports is reviewed from the perspective of the sideline medical provider. Skin injuries covered in this article include abrasions, lacerations, blisters, chafing, and sunburn. Sideline evaluations, treatment techniques, recommended equipment, and prevention are discussed. A well-equipped and prepared sideline provider can have a great impact on the proper care of acute sports skin injury and more rapid return to play.     

Hand Injuries in Football Players

In brief Football players have a fairly high brief risk of injury to the soft tissues of the hand; among the most common problems are thumb sprains and proximal interphalangeal joint dislocations. Stable ligament injuries can be treated with splints and casts, but more severe sprains may require surgical intervention. Closed tendon injuries must be followed carefully to prevent boutonniere deformity or mallet finger. Athletes with these injuries often can return quickly to play with protective splinting, but more recovery time may be necessary for ball handlers and for players who have injuries that require open reduction.     

Medical Aspects of White-Water Kayaking

In brief: Although white-water kayaking is an increasingly popular pastime, little is known about the specific medical problems encountered in this sport. To better delineate the frequency and nature of injuries associated with this activity, the author surveyed kayaking clubs and related organizations throughout the United States. Submersion-related injuries, upper extremity overuse syndromes, low back strain, and blisters were the most common problems reported. Dislocated shoulder was the most frequent serious orthopedic injury, although various types of fractures also were reported. Blunt head trauma, hypothermia, and gastroenteritis and other infectious problems also occurred.     

Epidemiology of injuries in Danish championship tennis

During the outdoor tennis season of 1984 a prospective injury registration was done in 104 randomly chosen elite tennis players, of whom 86% could be followed. We found 46 injuries: an incidence of 2.3 injuries/player/1000 tennis hours. Men were more frequently injured than women. The prevalence was 0.3 injury/player. Upper extremity injuries were most frequent - 45.7% (21/46). Shoulder injuries were the single most frequent injury - 17% (8/46). The pathophysiology was overuse in 67% (28/42), strains in 14% (6/42), sprains in 17% (7/42), fractures in 2% (1/42), and blisters in 5% (2/42). Players using conventional rackets had more injuries to the upper extremity compared with players using mid/oversized rackets, though the difference was nonsignificant. The importance of impact forces from the tennis stroke in the mechanism of upper extremity injuries is discussed.     

应用ReCell技术移植治疗稳定期白癜风的临床疗效观察

 目的 观察ReCell技术移植治疗稳定期白癜风的临床疗效。方法 选择2015-07至2017-07稳定期白癜风患者21例,黑素细胞来源采用正常皮肤发疱的方法,应用ReCell技术将疱壁制成含有黑素细胞的表皮细胞混悬液,将表皮细胞混悬液种植于白斑皮损创面,移植后观察临床治疗效果。结果 21例白癜风患者中的33块白癜风皮损进行了移植治疗,移植后皮损均出现程度不等的复色,移植后6个月的3、4级复色率达87.09%,移植后未见不良反应。结论 应用ReCell技术移植治疗稳定期白癜风,具有移植区复色效果好、供皮区不留瘢痕的优点,并且临床上安全性可靠,操作相对简单,不需要专门的实验室,值得临床推广应用。     

Sportsmedicine forum

In brief A variety of dermatologic problems affect the hands and feet of active patients, often producing significant pain and disability. Traumatic disorders include friction blisters, calcaneal petechiae, subungual hemorrhage, and plezogenic papules. Infectious disorders include hot tub folliculitis, swimming pool granuloma, tinea pedis, warts, and herpetic whitlow. Athletic shoe dermatitis is a common allergic disorder, and hand eczema is a common disorder with a strong hereditary component. Prompt diagnosis and treatment can minimize morbidity. Some traumatic disorders can be prevented.