Tinea gladiatorum prevalence among wrestlers in the era of required skin inspection

Transmittable skin infections in sport are a concern, especially for wrestlers. Current methods for limiting tinea gladiatorum transmission in United States high school wrestling include a required skin inspection protocol. Tinea prevalence before and after the skin inspection protocol was instituted is not widely known. We prospectively determined tinea prevalence among a Minnesota high school wrestler cohort over their 12-week season and compared this to point-in-time incidences reported in wrestlers not subject to a skin inspection protocol. Wrestlers having a suspicious rash at the skin inspection (raised, red, > 5 mm diameter, and with dry flaky scale) were recruited. Among suspicious rashes, tinea gladiatorum infection was determined using direct microscopy with chlorazol black staining. Thirty-eight of 510 wrestlers (7%) developed a rash suspicious for tinea. Thirty-four wrestlers that had rash(s) were enrolled and their rash was tested. Twenty-two of 510 wrestlers developed tinea gladiatorum throughout the season. Tinea gladiatorum prevalence was 4.3% (95% CI 2.5-6.1%). Four wrestlers with rash were not available for testing (unable to obtain timely consent (two) or obtain adequate sample(two)). Prevalence was less than suggested by the incidences previously reported in wrestling populations.