Commonly known as rug burn, strawberry, or road rash, abrasion may occur on any surface, but primarily artificial turf, floor mats, synthetic courts, and asphalt roads.

Treatment consists of cleaning and debriding the tissue with warm, soapy water and applying a topical antibacterial ointment.

Topical anesthesia facilitates easier exploration and debridement and may be achieved with 2% lidocaine jelly or one of several commercially available anesthetics (lidocaine, epinephrine, tetracaine [LET]; eutectic mixture of local anesthetics [EMLA]; Ela-Max) (23).

A thin covering of antibacterial ointment (mupirocin) or an adhesive hydrocolloid dressing (DuoDERM, OpSite) promotes healing (23).

Because of the risk of bloodborne pathogens and subsequent disease transmission, all wounds should be covered with an occlusive dressing during participation.

National Collegiate Athletic Association (NCAA) mandates that an athlete with active bleeding must be removed from competition, the bleeding stopped, and a dressing applied to withstand the rigors of competition prior to continued participation (8).

An occlusive obstruction of the follicular pilosebaceous units.

The pustular eruption commonly occurs in a warm, moist environment occluded by protective equipment across the back and shoulders or on the chin (15).

Wearing sweat-wicking underclothing, good personal hygiene, and regular cleaning of equipment help prevent outbreaks of lesions.

Acne mechanica in dark-skinned athletes may evolve into acne keloidalis on the nape of the neck (36).

The condition can be treated with various topical keratolytics with astringents (3% salicylic acid, 70% resorcinol) and antibiotics (tetracycline, clindamycin) (3).

Athletes should be clearly informed of side effects including muscle soreness, joint pain, and lethargy prior to the use of isotretinoin for severe pustular acne (3).

Fibrotic connective tissue (collagenomas) formed as a result of repetitive pressure, friction, or trauma over bony prominences.

Commonly located on knuckles (boxers, football players), tibial tuberosity (surfers), or dorsal feet (hockey “skate bites,” runners, hikers) (36).

Treatment includes intralesional steroids, protective taping and padding, and excision (36).

Resolve after the discontinuation of causal activity.

Black heel, or talon noir, refers to bluish-black petechiae within the stratum corneum on the posterior or posterolateral aspect of the heel caused by shearing forces between epidermis and dermis.

Commonly occurs in basketball, tennis, track, and similar events requiring sudden changes in direction.

A similar condition, black palm or tache noir, has been described in baseball players, golfers, gymnasts, mogul skiers, mountain climbers, and weightlifters (36).

Self-limiting and will resolve spontaneously once the season ends.

The use of heel cups, felt pads, cushioned athletic socks, and properly fitted footwear may help prevent black heel formation.

Rapid deceleration of the forefoot against the shoe toe box may produce painful subungual hemorrhages of the first and second toenail beds.

The condition occurs with greater frequency in sports requiring quick stops, such as tennis, skiing, hiking, and rock climbing (36).

The hematoma can be drained by carefully boring a hole through the nail with an 18-gauge needle or an electrocautery unit.

Appropriate running shoes (2 cm from the longest toe to the end of the shoe), lacing shoes tightly enough to prevent the foot from sliding forward, and properly trimming the distal nail to its shortest length in a straight cut line will reduce the likelihood of developing this condition (31).

Notable exceptions are the persistence of a linear black band or streak running the entire length of the nail representing a melanocytic nevus or the more serious involvement of the proximal nail fold as in malignant melanoma (2).

Vesicles or bullae filled with serosanguinous fluid or blood.

Repeated pressure or friction over bony prominences associated with excessive perspiration and improperly fitted equipment leads to the formation of blisters.

Treat early blisters with moleskin donuts and nylon foot stockings to decrease friction, talcum powder or antiperspirant to keep feet dry, and benzoin to harden the epidermis (15,30).

Bullous blisters should be drained at the edge with a small needle leaving the roof of the blister as a protective layer.

Ruptured and deroofed blisters may require the application of a hydrocolloidal dressing (DuoDERM) or an adhesive polyurethane dressing (OpSite) as a second-skin layer to reduce discomfort and enhance healing (5).

Primary prevention includes wearing properly fitted and broken-in footwear, use of absorbent socks or two pairs of socks of different materials, and applying petrolatum jelly or commercial antichafing preparations (Bodyglide) over bony prominences (21).

Corns are small, soft or hard, deep painful conical lesions with a translucent central core in the web spaces of the toes and the plantar surface over the distal heads of the metatarsals (36).

Calluses tend to be larger, hyperkeratotic, nonpainful lesions that serve as a protective skin layer and are considered an advantage in gymnastics, racquet sports, and rowing.

The development of small black dots representing thrombosed capillaries implies the presence of plantar warts, compared to calluses that display a thickened epidermis with intact dermatoglyphics.

The most important factor for successful recovery and prevention of the condition is redistributing pressure away from the lesion.

The shaping of a metatarsal pad to the plantar surface, creating a wider shoe toe box, adding cotton or foam padding between the toes, and applying moleskin will all aid in decreasing the pressure over the existing lesion and prevent further injury.

Keratolytic agents such as 5%-10% salicylic acid in colloid, 40% salicylic acid plaster, and 12% lactic acid will eliminate the lesions (26).

An inflammatory proliferation of fibrous tissue that is usually painless and is more prevalent in dark-skinned athletes.

Multiple, small keloids commonly develop where the headgear comes in contact with the forehead, cheeks, and posterior neck or where the undergarment pads cover the thighs, knees, and shoulders.

Treatment involves gradual reduction of the lesion with intralesional steroid injections or topical application of a steroid-impregnated adhesive tape (46).

This condition is caused by nail bed pressure forcing the lateral edge of the nail plate into the lateral nail fold.

The distal nail should be trimmed straight across, and at least one thumbnail in distance should exist from the longest distal toenail to the end of the shoe to prevent recurrence.

Acute treatment options include soaks in an Epsom salt or soapy water bath followed by application of topical antibiotic or a mid- to high-potency topical steroid, gentle manual nail elevation, placing a small piece of cotton or dental floss under the corner of the nail to elevate the lateral margin, use of antibiotics, and excision of the lateral one-third of the nail with electrodesication or chemical matricectomy with 80%-88% phenol (10,20).

Irritation and friction from coarse, cotton fabrics on an unprotected nipple and areola leading to pain and bleeding.

The majority of jogger’s nipples occur in male athletes, especially long-distance runners and triathletes (3).

Preventive measures include wearing of soft, natural, silk fiber shirts or no shirt or application of breast padding, electrocardiographic lead pads, band-aids, or a double coat of fingernail polish over the nipples prior to running to prevent chafing.

Treat by washing and gently drying and applying petroleum jelly, antibiotic ointment, or topical steroid cream to alleviate inflammation (31).

Flesh-colored papules noticeable only on weight-bearing are found in up to 20% of the general population.

Herniations of subdermal fat into the dermis visibly evident on either side of the heel.

Typically asymptomatic, but may become painful, possibly due to herniation of nerve fibers with subdermal fat (38).

More common in endurance athletes.

Padding, compression stockings, taping for support, heel cups, and steroid injections may help reduce the pain (38).

Rower’s rump develops in the gluteal cleft of rowers training on small, unpadded scull seats and metal rowing machines (42).

Repeated friction produces a lichen simplex chronicus of the buttocks.

Treatment consists of padding the rowing seat and the use of potent, fluorinated topical steroids.

A collection of ecchymotic lesions on the superior portion of the gluteal cleft of long-distance runners (3,31).

Results from constant friction between the gluteal folds with each running stride.

The hyperpigmentation will spontaneously resolve with rest.