Abietic acid dermatitis is a contact dermatitis

Contact dermatitis

Contact dermatitis is a term for a skin reaction resulting from exposure to allergens or irritants . Phototoxic dermatitis occurs when the allergen or irritant is activated by sunlight....

 often seen in association with musical instruments.

Causes

The main cause is a a type-I hypersensitivity reaction to products containing abietic acid

Abietic acid

Abietic acid , an organic compound that occurs widely in trees. It is the primary component of resin acid, is the primary irritant in pine wood and resin, isolated from rosin and is the most abundant of several closely related organic acids that constitute most of rosin, the solid portion of the...

, such as the rosin

Rosin

.Rosin, also called colophony or Greek pitch , is a solid form of resin obtained from pines and some other plants, mostly conifers, produced by heating fresh liquid resin to vaporize the volatile liquid terpene components. It is semi-transparent and varies in color from yellow to black...

/colophony, which is commonly used as a friction

Friction

Friction is the force resisting the relative motion of solid surfaces, fluid layers, and/or material elements sliding against each other. There are several types of friction:...

-increasing agent. Players of bowed string instrument

Bowed string instrument

Bowed string instruments are a subcategory of string instruments that are played by a bow rubbing the strings. The bow rubbing the string causes vibration which the instrument emits as sound.-Violin family:...

s (violin

Violin

The violin is a string instrument, usually with four strings tuned in perfect fifths. It is the smallest, highest-pitched member of the violin family of string instruments, which includes the viola and cello....

, viola

Viola

The viola is a bowed string instrument. It is the middle voice of the violin family, between the violin and the cello.- Form :The viola is similar in material and construction to the violin. A full-size viola's body is between and longer than the body of a full-size violin , with an average...

, cello

Cello

The cello is a bowed string instrument with four strings tuned in perfect fifths. It is a member of the violin family of musical instruments, which also includes the violin, viola, and double bass. Old forms of the instrument in the Baroque era are baryton and viol .A person who plays a cello is...

, double bass

Double bass

The double bass, also called the string bass, upright bass, standup bass or contrabass, is the largest and lowest-pitched bowed string instrument in the modern symphony orchestra, with strings usually tuned to E1, A1, D2 and G2...

) rub cakes or blocks of rosin on their bow

Bow (music)

In music, a bow is moved across some part of a musical instrument, causing vibration which the instrument emits as sound. The vast majority of bows are used with string instruments, although some bows are used with musical saws and other bowed idiophones....

 so it can grip the strings. Ballet

Ballet

Ballet is a type of performance dance, that originated in the Italian Renaissance courts of the 15th century, and which was further developed in France and Russia as a concert dance form. The early portions preceded the invention of the proscenium stage and were presented in large chambers with...

 and flamenco

Flamenco

Flamenco is a genre of music and dance which has its foundation in Andalusian music and dance and in whose evolution Andalusian Gypsies played an important part....

 dancers sometimes rub their shoes in powdered rosin to reduce slippage before going on stage. Gymnast

Gymnast

Gymnasts are people who participate in the sports of either artistic gymnastics, trampolining, or rhythmic gymnastics.See gymnasium for the origin of the word gymnast from gymnastikos.-Female artistic:Australia...

s, baseball

Baseball

Baseball is a bat-and-ball sport played between two teams of nine players each. The aim is to score runs by hitting a thrown ball with a bat and touching a series of four bases arranged at the corners of a ninety-foot diamond...

 pitcher

Pitcher

In baseball, the pitcher is the player who throwsthe baseball from the pitcher's mound toward the catcher to begin each play, with the goal of retiring a batter, who attempts to either make contact with the pitched ball or draw a walk. In the numbering system used to record defensive plays, the...

s and ten pin bowler

Ten-pin bowling

Ten-pin bowling is a competitive sport in which a player rolls a bowling ball down a wooden or synthetic lane with the objective of scoring points by knocking down as many pins as possible.-Summary:The lane is bordered along its length by semicylindrical channels Ten-pin bowling (commonly just...

s use rosin to improve grip. Common locations of this contact dermatitis

Contact dermatitis

Contact dermatitis is a term for a skin reaction resulting from exposure to allergens or irritants . Phototoxic dermatitis occurs when the allergen or irritant is activated by sunlight....

 are hand

Hand

A hand is a prehensile, multi-fingered extremity located at the end of an arm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs...

s, face

Face

The face is a central sense organ complex, for those animals that have one, normally on the ventral surface of the head, and can, depending on the definition in the human case, include the hair, forehead, eyebrow, eyelashes, eyes, nose, ears, cheeks, mouth, lips, philtrum, temple, teeth, skin, and...

 and neck

Neck

The neck is the part of the body, on many terrestrial or secondarily aquatic vertebrates, that distinguishes the head from the torso or trunk. The adjective signifying "of the neck" is cervical .-Boner anatomy: The cervical spine:The cervical portion of the human spine comprises seven boney...

.

Differential diagnosis

Cutaneous disorders in musicians include frictional injury

Wear

In materials science, wear is erosion or sideways displacement of material from its "derivative" and original position on a solid surface performed by the action of another surface....

 ("fiddler

Fiddler

A fiddler is a person who plays a fiddle or violin.Fiddler may also refer to:*Fabrangen Fiddlers, an American musical group founded in 1971*Tupolev Tu-28 "Fiddler", a fighter aircraft*Fiddler , a DC Comics villain...

's neck

Neck

The neck is the part of the body, on many terrestrial or secondarily aquatic vertebrates, that distinguishes the head from the torso or trunk. The adjective signifying "of the neck" is cervical .-Boner anatomy: The cervical spine:The cervical portion of the human spine comprises seven boney...

"), hyperhidrosis

Hyperhidrosis

Hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature.-Classification:Hyperhidrosis can either be generalized or localized to specific parts of the body...

, acne mechanica

Acne mechanica

Acne mechanica is an acneiform eruption that has been observed after repetitive physical trauma to the skin such as rubbing, occurring from clothing or sports equipment ....

 and vascular

Vascular

Vascular in zoology and medicine means "related to blood vessels", which are part of the circulatory system. An organ or tissue that is vascularized is heavily endowed with blood vessels and thus richly supplied with blood....

 compromise. Other agents of irritant and allergic contact dermatitis may be rosewood

Rosewood

Rosewood refers to any of a number of richly hued timbers, often brownish with darker veining, but found in many different hues. All rosewoods are strong and heavy, taking an excellent polish, being suitable for guitars, marimbas, turnery , handles, furniture, luxury flooring, etc.In general,...

, Makassar ebony, cocobolo

Cocobolo

Cocobolo is a tropical hardwood of the tree Dalbergia retusa from Central America.Only the heartwood is used: this is typically orange or reddish-brown in color, often with a figuring of darker irregular traces weaving through the wood. The sapwood is a creamy yellow, with a sharp boundary with...

 wood, African blackwood

African Blackwood

Dalbergia melanoxylon is a flowering plant in the family Fabaceae, native to seasonally dry regions of Africa from Senegal east to Eritrea and south to the Transvaal in South Africa....

, nickel

Nickel

Nickel is a chemical element with the chemical symbol Ni and atomic number 28. It is a silvery-white lustrous metal with a slight golden tinge. Nickel belongs to the transition metals and is hard and ductile...

, reed

Reed (instrument)

A reed is a thin strip of material which vibrates to produce a sound on a musical instrument. The reeds of most Woodwind instruments are made from Arundo donax or synthetic material; tuned reeds are made of metal or synthetics.-Single reeds:Single reeds are used on the mouthpieces of clarinets...

, propolis

Propolis

Propolis is a resinous mixture that honey bees collect from tree buds, sap flows, or other botanical sources. It is used as a sealant for unwanted open spaces in the hive. Propolis is used for small gaps , while larger spaces are usually filled with beeswax. Its color varies depending on its...

 (bee glue), chromium

Chromium

Chromium is a chemical element which has the symbol Cr and atomic number 24. It is the first element in Group 6. It is a steely-gray, lustrous, hard metal that takes a high polish and has a high melting point. It is also odorless, tasteless, and malleable...

 and paraphenylenediamine. Patch testing can be performed for identification of the cause.

Treatment

Treatment may include corticoids, astringent

Astringent

An astringent substance is a chemical compound that tends to shrink or constrict body tissues, usually locally after topical medicinal application. The word "astringent" derives from Latin adstringere, meaning "to bind fast"...

s and keratolytic

Keratolytic

Keratolytic therapy is treatment to remove warts and other lesions in which the epidermis produces excess skin. In this therapy, acid medicine, such as salicylic acid is put on the lesion. Keratolytic therapy thins the skin on and around the lesion. It causes the outer layer of the skin to loosen...

s. Dermatoses tend to be recurrent unless the use or contact can be avoided. Discontinuation of the instrument is curative in almost all cases but usually impractical.