Musicians

Abstract

The incidence of dermatological problems in musicians is possible about 25% but ranges according to the literature from uncommon to high-nearly 50%. The problems are significantly correlated to the amount of time practised and more than 5 years practising. Most problems are seen in string, wind, and percussion players. The clinical aspects of the lesions vary from contact dermatitis to the results of all sorts of mechanical influences. Callosities are frequently seen and to a certain extend desirable in, for example, string players. Mechanical influences in special contact places may evoke typical lesions like: fiddler’s neck, cellist’s chest, guitar nipple, flutist’s chin, Garrod’s pads, paronychia, or cheillitis. A small group of allergens are important in allergic contact dermatitis in musicians. The allergens come from the instruments or attachments, polishes, and waxes. Most often, colophony, propolis, nickel, dichromate, and sometimes a variety of exotic woods or cane reed. A full diagnostic workup is required to investigate a musician with skin problems, including an extensive history, patch testing, observation of the performing musician, and sometimes inspection of the workplace. Dermatoses can be so severe that they threaten the career of the musician. Prevent long sick leaves, the sooner the musician can play again the better. Avoiding of the responsible allergens and irritants and often adjustment of the playing technique are essential.