Tinea gladiatorum: Pennsylvania's experience.

Objective: To describe the impact of ringworm infections in high school wrestlers (tinea gladiatorum) in Pennsylvania during the 1998-1999 scholastic wrestling season.

Design: Retrospective 23-item mail-out survey.

Setting: Pennsylvania high schools with varsity wrestling programs in 1998-1999.

Participants: Athletic trainers, athletic directors, and wrestling coaches who responded to the mail-out survey.

Main Outcome Measures: Frequency of ringworm infection during the 1998-1999 season. Methods of prevention, diagnosis, and treatment of ringworm among respondent schools. Summary of beliefs concerning transmission and the way ringworm is approached compared with other skin infections. Any associations between the methods of prevention, diagnosis, and treatment and the frequency of ringworm infections.

Results: Response rate was 42.4%. Of the respondent schools, 84.7% had at least one wrestler diagnosed with ringworm. Of these teams with infected wrestlers 33% had a wrestler miss a match because of the infection. A majority of schools (68.7%) have a written guideline for return after a ringworm infection. Most respondents believe ringworm is transmitted by personal contact or from contact with mats. An overwhelming majority of schools (97%) use preventive practices. Interestingly, schools that used a greater number of preventive practices had more ringworm infections (p < 0.05). Larger teams were associated with more ringworm infections. In the respondent schools, 60% of coaches were involved in making a diagnosis of ringworm. Return decisions are made predominantly by a physician and/or the athletic trainer (79%).

Conclusions: Ringworm infections in wrestlers are a common occurrence. There is a lot of variation among schools in Pennsylvania in regard to prevention, diagnosis, treatment, guidelines, and beliefs about ringworm. More study is needed to determine risk factors, transmission patterns, microbiology patterns, and evidence-based prevention and treatment recommendations.