Musicians

• The prevalence of dermatological problems in musicians ranges from 20% to nearly 50%. It increases with experience (beginner, musicology student, part-time or full-time artist, amateur or professional), the duration and frequency of the rehearsals, and instruments (string, wind, or percussions). The clinical aspects of the lesions include mainly calluses and callosities, but also localized hyperpigmentation or hypopigmentation, and nail dystrophia. Contact dermatitis as the results of all sorts of mechanical influences presents as chronic contact eczema where the instrument is applied. A wide number of “specific” lesions have been described according to the instrument: fiddler’s neck, cellist’s chest, guitar nipple, flutist’s chin, Garrod’s pads, harpist’s fingers, or clarinetist’s cheilitis. • A small group of allergens is important in allergic contact dermatitis in musicians. The allergens come from the instruments or attachments, polishes, and waxes. Most often, colophony, propolis, nickel, potassium 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.