Dermatitis in Stringed Instrumentalists

Abstract

Purpose: Up to 25% of stringed instrumentalists suffer from dermatological issues. Although occupational contact dermatitis alone has been estimated to cost the United States a billion dollars in economic burdens there has yet to be a focused review of dermatologic diseases in stringed instrumentalists. The objective of this systematic literature review is to identify dermatologic diseases of stringed musicians and summarize the available treatment options. Methods: A literature search of PubMed, Scopus, and Medline were conducted for articles relevant to skin diseases in musicians. Two investigators independently reviewed and narrowed the search to 32 articles based on the inclusion criteria of stringed instruments. Data was then abstracted with a focus on violin, viola, cello, bass, guitar, and harp. Results: Stringed instrumentalists commonly had the highest practice frequencies (p=0.0.31). This was associated with instrument-related skin disorders (p=0.022) such as callosities. Fiddler's Neck was the most commonly reported finding in violinists and violists. the most common cause of allergic contact dermatitis were nickel and colophony. Mastitis was reported in guitarists and finger trauma in harpists. Beginner status made individuals more susceptible to dermatologic issues. Data on cello and bass players is lacking. Non-pharmacological treatments included cessation of playing, proper posture, modified instrument set-ups, and physical barriers between the instrument and skin. Conclusions: Stringed instrumentalists have a unique set of dermatological conditions. Further research is needed to investigate the local musician populations, promote proper body mechanics, and develop instrument set-ups that do not cause dermatological conditions.