[Outbreak of cutaneous dermatophytosis in the Judo French Programme in Orleans: September 2004-June 2005].
BACKGROUND
High contact sports regularly allow transmission of infectious agents, including fungi such as dermatophytes. The occurrence of dermatophytosis outbreaks among wrestlers has been extensively described since the 90s. The emergence of such outbreaks among judokas was described for the first time in December 2004. We report here an outbreak which occurred in a high level judo team and is, to our knowledge, the largest ever published.


METHODS
From October 2004 to June 2005, every judokas of the Pôle France Orléans who were suspect of dermatophytosis were addressed to one single dermatologist. Lesions were sampled for fungal culture and their anatomical cartography was extensively raised. Two protocols of treatment were defined.


RESULTS
97 medical appointments occurred over the period, leading to 74 clinically-defined episodes of dermatophytosis, distributed as 51 primo-contaminations and 23 re-contaminations (new episode in an individual who was considered cured). The distribution of the lesions on the body was: forearms > anterior trunk > neck and face > scalp. Among the 74 episodes, 53 could grow Trichophyton tonsurans. Infected athletes received oral and topical antifungal treatments. No adverse effects were noticed.


CONCLUSIONS
This series among judokas is the largest ever published. It allowed the description of the specific clinical and anatomical presentation of tinea corporis gladiatorum, emphasising that contamination takes place through direct skin to skin contacts during practice. T. tonsurans is regularly the responsible fungus in recently published series. Caring for such an outbreak raises specific problems because of the numerous structures involved and of the nature of these structures and of the sportive goals they aim at.


CONCLUSIONS
This outbreak is probably part of a wider one diffusing among high level judo teams. Stopping it requires the cooperation of several distinct actors, among which sports federations as well as sports-related physicians and dermatologists should play a major role.
Estève
E
E
Service de Dermatologie, CHR Orléans, Hôpital Porte Madeleine, Orléans. eric.esteve@chr-orleans.fr
Rousseau
D
D
Defo
D
D
Poisson
D-M
DM
D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D003881:Dermatomycoses / Q000188:drug therapy / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D016139:Martial Arts
D000935:Antifungal Agents