Caero Jennifer E, Cohen Philip R
The University of Texas Medical School at Houston, Houston, Texas, USA.
Dermatol Online J. 2012 Sep 15;18(9):10.
Fiddler's neck refers to an irritant contact dermatitis on the submandibular neck of violin and viola players and an allergic contact dermatitis to nickel from the bracket attaching the violin to the chin rest on the violinist's supraclavicular neck. A 26-year-old woman developed submandibular and supraclavicular left neck lesions corresponding to the locations of the chin rest and bracket that was attached to her violin that held it against her neck when she played. Substitution of a composite chin rest, which did not contain nickel, and the short-term application of a low potency topical corticosteroid cream, resulted in complete resolution of the allergic contact dermatitis supraclavicular neck lesion. The irritant contact dermatitis submandibular neck lesion persisted. In conclusion, violin players are predisposed to developing irritant contact dermatitis or allergic contact dermatitis from the chin rest. We respectfully suggest that the submandibular neck lesions from contact with the chin rest be referred to as 'fiddler's neck - type 1,' whereas the supraclavicular neck lesions resulting from contact of the bracket holding the chin rest in place be called 'fiddler's neck - type 2.' A composite chin rest should be considered in patients with a preceding history of allergic contact dermatitis to nickel.
小提琴手颈部皮炎是指小提琴和中提琴演奏者下颌下颈部的刺激性接触性皮炎，以及小提琴手锁骨上颈部因将小提琴固定在腮托上的托架含镍而引起的过敏性接触性皮炎。一名26岁女性的下颌下和左锁骨上颈部出现皮损，与她演奏时抵在颈部的小提琴腮托和托架的位置相对应。更换不含镍的复合腮托，并短期外用低效局部糖皮质激素乳膏后，锁骨上颈部的过敏性接触性皮炎皮损完全消退。下颌下颈部的刺激性接触性皮炎皮损仍持续存在。总之，小提琴演奏者易因腮托而发生刺激性接触性皮炎或过敏性接触性皮炎。我们建议将因接触腮托引起的下颌下颈部皮损称为“小提琴手颈部皮炎1型”，而将因固定腮托的托架接触引起的锁骨上颈部皮损称为“小提琴手颈部皮炎2型”。对于有镍过敏性接触性皮炎病史的患者，应考虑使用复合腮托。
