Ann Dermatol.  2010 Feb;22(1):88-90. 10.5021/ad.2010.22.1.88.

Fiddler's Neck Accompanied by Allergic Contact Dermatitis to Nickel in a Viola Player

Affiliations
  • 1Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea. romio@hanyang.ac.kr

Abstract

"Fiddler's neck" is an irritant contact dermatitis that frequently affects violin and viola players. The etiology of the skin changes associated with this condition are probably attributable to a combination of factors--including increased pressure, friction, poor hygiene, and excessive perspiration. Clinically, the lesions generally consist of a localized area of lichenification on the left side of the neck just below the angle of the jaw. Herein, we report a case of fiddler's neck in a viola player, attended by allergic contact dermatitis to the nickel in the metal fixtures of a viola. We hope that our case report draws the attention of dermatologists toward this, and many other skin problems that affect musicians.

Keyword

Allergic contact dermatitis; Fiddler's neck; Viola player

MeSH Terms

Dermatitis, Allergic Contact
Dermatitis, Contact
Friction
Hygiene
Jaw
Neck
Nickel
Skin
Viola
Nickel

Figure

  • Fig. 1 (A) A hyperpigmented lichenified plaque on the neck just below the angle of the patient's left mandible (thick arrow) and erythematous scaly plaques on the left lower neck (thin arrow). (B) Performance position of the viola player.

  • Fig. 2 Patch test results to nickel sulfate. (A) After 48 hours, (B) After 96 hours. (C, D) Metallic part of viola (arrow) showed a strong reaction to the dimethylglyoxime test.


Reference

1. Gambichler T, Uzun A, Boms S, Altmeyer P, Altenmuller E. Skin conditions in instrumental musicians: a self-reported survey. Contact Dermatitis. 2008. 58:217–222.
Article
2. Gambichler T, Boms S, Freitag M. Contact dermatitis and other skin conditions in instrumental musicians. BMC Dermatol. 2004. 4:3.
Article
3. Onder M, Aksakal AB, Oztas MO, Gurer MA. Skin problems of musicians. Int J Dermatol. 1999. 38:192–195.
Article
4. Kennedy CTC, Burd DAR. Burns T, Breathnach S, Cox N, Griffiths C, editors. Mechanical and thermal injury. Rook's textbook of dermatology. 2004. 7th ed. Oxford: Blackwell Science;22.26–22.27.
Article
5. Pincelli C, Motolese A, Pincelli L. Fiddler's neck and nickel dermatitis. Contact Dermatitis. 1985. 13:37.
Article
6. Peachey RD, Matthews CN. 'Fiddler's neck'. Br J Dermatol. 1978. 98:669–674.
Article
7. Kuner N, Jappe U. Allergic contact dermatitis from colophonium, turpentine and ebony in a violinist presenting as fiddler's neck. Contact Dermatitis. 2004. 50:258–259.
Article
8. Hann SK, Kim DH, Lee SN. A case of fiddler's neck. Korean J Dermatol. 1986. 24:671–673.
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