Allergy and skin diseases in musicians

In order to define a standard diagnostic protocol for managing allergic dis-eases in musicians, we conducted a literature search on this topic. The most frequent allergic disease in this special category of workers was contact dermatitis, always described in stringed and wind instruments players, involving the mouth and the hands. No other allergic disease directly related to musical instruments was reported. The most frequently reported culprit substances were: colophony, exotic woods, nickel sulphate, varnishes, and propolis (bee glue). Thus, being contact dermatitis the most frequent disease, a correct diagnostic approach to this problem in musicians should involve, in addition to clinical history and examination, the patch test with a specific panel of substances. Finally, allergy in musicians involves additional problems: the virtual impossibility to avoid the offending substance, and the poor adherence to therapy due to lifestyle. In general, this specific allergologic problem seems to be underestimated, underdiagnosed and, as a conquence, poorly managed.