Fiddler's neck , sometimes referred to as "hickey fiddle," or "viola love bite" is a work-related illness that affects violinists and violins.
This is a skin condition usually characterized by redness, thickening, and inflammation on the left side of the neck beneath the angle of the jaw where the instrument is held. Lesions such as acne and cysts can form on site due to foreign body reactions, and infections may also occur due to poor hygiene. The main causes of the fiddler's neck are constant friction and local pressure. It is famous among professional orchestra musicians but is "unfamiliar to the dermatologist", and the red mark on the left side of the neck below the jaw "serves as an identification mark" of the violinist or violinist "in public without looking at the instrument" < i>.
Although the presence of the neck of a violinist is sometimes used as an indicator of a violinist's skill, or 'battle marks' of continuous practice, many violinists never develop a fiddler's neck, due to differences in skin sensitivity, play habits, and materials used in construction. instrument. Experienced professionals can train hard for a lifetime and never develop a fiddler's neck.
Video Fiddler's neck
Signs and symptoms
Fiddler's neck usually involves highly localized lichenification, mild hyperpigmentation, and erythema in which the chin rests or presses the instrument's body against the skin of the neck. Other signs and symptoms include buildup of scales, cysts and scar formation, papules and pustules associated with local infection, and focal edema. In Blum & amp; Ritter's research in West Germany (1990) found that 27% of their population had only minor problems, 72% had a palpable mass on site, and 23% reported pain and other signs of inflammation such as hyperthermia, pulsation, and cystic , pustular, or papular lesions. The average mass size of 2 cm in diameter ranges up to 4 cm, some associated with purulent drainage, continuous discharge, and hardening of the skin. Dystrophi calcinosis cutis has also been reported. Other serious sequelae include sialolithiasis of the submandibular gland and adenolymphoma of the parotid gland.
Fiddler neck histopathology often indicates hyperkeratosis and acanthosis, along with inserting follicles. Histiocytic infiltration with granulomas in foreign bodies and follicular cysts is also common. The foreign body granuloma is thought to originate from the abrasion of the wood surface from the chin and its absorption into the superficial dermis. The location and complex mechanism of the cause for the fiddler neck lead to a wider spectrum of skin changes when compared with contact dermatitis than more generalized irritations. Fiddler's neck can be distinguished from the reaction of rosacea and sarcoid with granuloma.
Maps Fiddler's neck
Cause
The proximal causes of the fiddler's neck are friction and pressure, but both recurrent shear stress and occlusion with the sweat trap of sweat cause progressive damage. This damage along with poor hygiene will affect the area to local infection, and the infection may develop into scarring and other long-term effects. Hot weather is reported to worsen the fiddler's neck, such as fatigue, playing emotional music, and playing in smaller groups where individual stress is higher. Hypersensitivity reactions of type I can also be involved, especially for rosewood and ebony in chinrest and tailpiece, as well as varnish from the body of the instrument when chinrests are not used and for rosin deposits on instruments and on chin fabrics. Nickel or other metal allergies are a common cause if the resting chin has a metal clip that comes in contact with the skin constantly. Exposure to rosin can in particular cause abietic acid dermatitis.
Diagnosis
Differential diagnosis
The differential diagnosis of the fiddler neck includes a branchial biliary cyst, salivary gland disease, parotid gland tumor, psoriasis, lichen planus, contact dermatitis, herpes simplex and similar infections, and insect and sting bites particularly from ticks.
Treatment
Treatment for fiddler neck is not necessary if it does not cause pain and shows minimal swelling, especially since small cases are taken as a sign of pride. But the fiddler's neck can cause worse distractions. The primary method of care involves adjustments to play the instrument:
- good cleanliness for the affected area and for instruments
- the use of a frequently replaced cotton cloth
- the use of the shoulders to reduce the pressure under the jaw
- the rest of a suitable chin, especially one carved or shaped for an individual
- Closes or replaces materials that potentially cause allergies to the instrument.
- shifting the chin to the center of the body above the tailpiece
- smooths rough surfaces to reduce abrasion
- for men, grow a beard to avoid folliculitis
Surgery is needed for sialolithiasis, parotid tumors, and cysts. Cervical lymph nodes greater than 1 cm should be biopsied. The connective tissue can be removed by excision when the mass is not inflamed large, and there is generally a slight recurrence. Infection should be treated conservatively, and the causative species should be identified through the smear and culture for appropriate antibiotic selection. Reduced play time may be helpful for cases without inflammation, but in 30% of these cases did not improve symptoms.
Prevalence
Fiddler's neck is usually not formed unless the musician is practicing or playing for more than a few hours every day, and seems to only develop after several years of serious play. Thus, when uninfected or problematic, the fiddler neck can be known as a sign of a harmless exercise and can be worn proudly as an indication of long working hours. Blum & amp; Ritter (1990) found that 62% of the 523 professional violinists and violinists in West Germany experienced fiddler necks, with the percentage among violinists higher (67%) than among violinists (59%). Viola players are believed to be more likely to develop fiddler necks than violinists because the violin is bigger and heavier, but this has not been confirmed empirically.
The development of the fiddler neck does not depend on pre-existing skin problems, and Blum & amp; Ritter found that only 23% of men and 14% of women in their study reported skin disorders in other facial parts (especially acne and eczema) that independently played violins or violins. Fiddler's neck can aggravate existing acne, but acne can also be limited to lesions and does not appear anywhere else. Nonetheless, musicians with underlying skin diseases such as acne and eczema are more threatened by the fiddler's neck than others. Men can develop folliculitis or ulcers due to the involvement of the beard hair.
References
Source of the article : Wikipedia
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