Occupational Diseases Codexery

Fiddler's neck

Occupational skin condition from violin or viola playing.

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Acne-like lesions, cysts, and infections may occur at the site due to friction, pressure, and poor hygiene.[1] Violin and viola players can develop an occupational skin condition on the left side of the neck, below the jaw angle, where the instrument is held; this condition, known as fiddler's neck, involves redness, thickening, and inflammation.[2][1]

Quick Facts

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Occupational health

Facts from the source article.

Key facts and history

Repetitive shearing stress and occlusion trapping sweat cause progressive damage, and poor hygiene predisposes the area to local infection.[3] Type I hypersensitivity reactions may involve rosewood, ebony, varnish, rosin, or nickel from chin rest clips.[3][4] The condition is well known among professional orchestra musicians but "not well recognized by dermatologists."[1] A red mark on the left side of the neck under the jaw serves as an identifying sign of a violinist or violist in public.[1]

Minor cases are often taken as a mark of pride and require no treatment.[4] Local pressure and ongoing friction are the main reasons fiddler's neck develops.[1] According to reports, the condition can be made worse by hot weather, fatigue, performing emotionally charged music, and playing in small ensembles.[3] A musician typically does not get fiddler's neck unless they have been playing seriously for several years and practice more than a few hours daily.[5]

In a 1990 study by Blum and Ritter involving 523 professional violinists and violists in West Germany, 62% had fiddler's neck; the rate was 67% for violists and 59% for violinists.[5]

What the research sources say

Surgery is necessary for sialolithiasis, parotid tumors, and cysts, and cervical lymph nodes larger than 1 cm must be biopsied.[6] The 1990 Blum and Ritter study noted that 27% of their subjects had only minor problems, 72% had a lump that could be felt at the site, and 23% experienced pain and signs of inflammation.[7] Those lumps averaged 2 cm in diameter, with some reaching 4 cm; a few cases involved pus drainage, ongoing discharge, and crust formation.[7] Under the microscope, the tissue often shows hyperkeratosis, acanthosis, and blocked follicles, along with histiocytic infiltration and foreign-body granulomas.[8]

It is believed that foreign body granulomas result from the wooden chin rest surface being abraded and then absorbed into the upper layer of the skin.[8]

References

  1. Wikipedia, "Fiddler's neck" (CC BY-SA 4.0), which cites: Gambichler, "Contact dermatitis and other skin conditions in instrumental musicians", BMC Dermatology, 2004, p. 3; Gambichler, "Contact dermatitis and other skin conditions in instrumental musicians", BMC Dermatology, 2004, p. 3; Peachey, "'Fiddler's neck'", The British Journal of Dermatology, 1978, p. 669–674; Peachey, "'Fiddler's neck'", The British Journal of Dermatology, 1978, p. 669–674; Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, en.wikipedia.org
  2. Wikipedia, "Fiddler's neck" (CC BY-SA 4.0), which cites: Wickam, "The Pesky... Violin Hickey! - Quick Tip - Vi Wickam", Vi Wickam, 2018-12-20; Gambichler, "Contact dermatitis and other skin conditions in instrumental musicians", BMC Dermatology, 2004, p. 3 (original not read by us) en.wikipedia.org
  3. Wikipedia, "Fiddler's neck" (CC BY-SA 4.0), which cites: Gambichler, "Contact dermatitis and other skin conditions in instrumental musicians", BMC Dermatology, 2004, p. 3; Gambichler, "Contact dermatitis and other skin conditions in instrumental musicians", BMC Dermatology, 2004, p. 3; Peachey, "'Fiddler's neck'", The British Journal of Dermatology, 1978, p. 669–674; Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160 (original not read by us) en.wikipedia.org
  4. Wikipedia, "Fiddler's neck" (CC BY-SA 4.0), which cites: Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160 (original not read by us) en.wikipedia.org
  5. Wikipedia, "Fiddler's neck" (CC BY-SA 4.0), which cites: Peachey, "'Fiddler's neck'", The British Journal of Dermatology, 1978, p. 669–674; Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160; Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160; Peachey, "'Fiddler's neck'", The British Journal of Dermatology, 1978, p. 669–674 (original not read by us) en.wikipedia.org
  6. Wikipedia, "Fiddler's neck" (CC BY-SA 4.0), which cites: Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160; Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160; Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160; Blum, "Violinists en.wikipedia.org
  7. Wikipedia, "Fiddler's neck" (CC BY-SA 4.0), which cites: Peachey, "'Fiddler's neck'", The British Journal of Dermatology, 1978, p. 669–674; Gambichler, "Contact dermatitis and other skin conditions in instrumental musicians", BMC Dermatology, 2004, p. 3; Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160 (original not read by us) en.wikipedia.org
  8. Wikipedia, "Fiddler's neck" (CC BY-SA 4.0), which cites: Peachey, "'Fiddler's neck'", The British Journal of Dermatology, 1978, p. 669–674; Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160; Blum, "Violinists and violists with masses under the left side angle of the jaw known as "fiddler's neck"", Medical Problems of Performing Artists, December 1990, p. 155–160; Gambichler, "Contact dermatitis and other skin conditions in instrumental musicians", BMC Dermatology, 2004, p en.wikipedia.org

Each numbered sentence above was checked against the source it cites before publication. Sentences citing Wikipedia adapt text from the English Wikipedia article Fiddler's neck (contributors), used under CC BY-SA 4.0; this entry is available under the same licence. Other sources were used for facts only; no text or images are copied from them.

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Compiled from Wikipedia and the sources listed below. Text from Wikipedia is available under CC BY-SA 4.0; this entry is adapted from it.

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