# A Unique Acquired Athletic Dermatologic Condition in a Half Marathon Participant: An Autobiographical Case Report of Sports-Associated Clothing Related Axillary Tangled Clumped Hairs (SCRATCH)

## TL;DR

A 66-year-old runner developed a unique skin condition called SCRATCH due to friction from his shirt during a half marathon.

## Contribution

The paper introduces SCRATCH as a novel sports-related dermatologic condition caused by clothing friction and axillary hair tangling.

## Key findings

- SCRATCH causes painful clumps of tangled axillary hairs and temporary alopecia.
- The condition does not occur in individuals who shave their axillary hairs.
- Prevention methods include shaving axillary hairs, using salve, or wearing non-irritating shirts.

## Abstract

Runners are susceptible to developing sports-related disorders. A 66-year-old man developed a unique cutaneous condition affecting his armpits while participating in a 13.1-mile race. Friction from the shirt he was wearing resulted in the development of sports-associated clothing related axillary tangled clumped hairs (SCRATCH). Removal of the hairs that had become tangled and clumped resulted in temporary localized patches of alopecia. The incidence of SCRATCH remains to be established. The condition results from the seams of the shirt rubbing against the axillary hairs and creating a mass of tangled and clumped hairs that are painful when the runner moves their arms. Removal of the hair masses can result in focal areas of alopecia in the affected axillae; subsequently, the tractional alopecia created by the hair removal resolves. SCRATCH does not occur in individuals who regularly shave their axillary hairs. The condition can be prevented by shaving or cutting the axillary hairs prior to running, possibly by applying a salve to the axillary hairs so that they do not adhere to the shirt, or by wearing shirts that do not rub against the axillae. A comprehensive summary of sports-associated dermatologic conditions in runners is presented. In conclusion, individuals who participate in ambulatory activities are susceptible to many dermatologic conditions related to their sport and SCRATCH can be added to the list of potential cutaneous disorders that can occur in runners.