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Dermatitis Palaestrae Limosae

Amanda I. Adler, MD, PhD; Jeff Altman, MD

JAMA. 1993;269(4):502-504.

Abstract
Objective.
—To investigate an outbreak of gram-negative folliculitis in relation to a common exposure, mud wrestling, and identify risk factors for dermatitis among those who mud wrestled.

Design.
—Case-control study.

Setting.
—University of Washington, Seattle.

Participants.
—Two college-residence groups of students.

Results.
—Cultures from affected students and from mud similar to that used for wrestling yielded Enterobacteriaceae. The odds ratio associated with mud wrestling was 79.5 (95% confidence interval, 13.9 to 895.4). Increased time spent wrestling was associated with increased risk. Skin trauma during wrestling or immersion in the mud increased the risk of infection (odds ratio, 23.1; 95% confidence interval, 1.7 to 1440.4).

Conclusions.
—Mud wrestling is one cause of pustular follicular dermatitis. Trauma to the skin may be a necessary cofactor for the development of infection.

(JAMA. 1993;269:502-504)

Author Affiliations
From the Student Health Center (Drs Adler and Altman), and the Departments of Epidemiology (Dr Adler), Medicine (Dr Adler), and Family Medicine (Dr Altman), University of Washington, Seattle.

Footnotes
Reprint requests to Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1124 Columbia St (MP 381), Seattle, WA 98104 (Dr Adler).

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