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12
Skin Defects
The number of skin defects reported at medical inspections showed a
slight reduction during the year.
The proportion of skin defects in boys and girls shows an interesting
variation with age. In the primary schools the experience of the two groups
is similar with a slight increase in incidence with age. In secondary schools
the girls continue this trend whereas the boys show a sudden and dramatic
increase in incidence (Table 4). An important factor in this pattern is the
condition known as Athlete's Foot. This condition is accompanied by
scaling of the skin and maceration between the toes. In most cases it results
from infection by a fungus (tinea pedis) and several surveys have
demonstrated its spread through communal showering facilities. In other
cases the symptoms are precipitated by excessive sweating and poor foot
hygiene without any specific infective organism. It is not usually a serious
condition but it does cause discomfort and the risk of secondary infection.
Hitherto the service has provided advice on good foot hygiene especially the
need to wash the feet regularly even after a visit to the swimming baths, and
to dry the skin carefully between the toes without vigorous rubbing. Such
actions certainly help to prevent the condition but there has been increasing
pressure upon the Service to provide treatment facilities.
After discussion with the British Medical Association, it has been
agreed that the Service should identify and diagnose those cases which are
due to a fungal infection. This will necessitate a minor laboratory investigation.
Thereafter the Service will ask the family doctor whether he wishes to
to provide appropriate treatment. Sometimes cases cannot easily be supervised
in a busy surgery and the School Health Service will then provide
medicaments and a regular review through the existing school clinics which
already provide treatment for many skin conditions.
The incidence of plantar warts (verrucae) was again troublesome. The
discomfort and long period of exclusion from sporting activities which are
associated with the condition naturally prompts parents to consider possible
preventive measures. The Service regularly receives letters of complaint
asking that barefoot activity in school should be prohibited on medical
grounds. It is indeed unfortunate that barefoot physical education is so
actively encouraged by those who advise on educational matters since, as
Dr. Thelma Wield points out, "it seems that the risk of infection from this