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Contact cheilitis and other reactions involving the lips of musicians.

Cheilitis means inflammation of the lips swelling and other reactions of the lips and adjacent The skin may be due to contact with the mouthpieces of musical instruments, especially brass and brass instruments.

1. Dry red lips and calluses

The sound on brass instruments is created by the vibration of the lips inside a cup-shaped mouthpiece. Friction between the lips and the mouthpiece can produce painful, red and dry lips and is not related to allergy. A callus may develop on the upper lip. Clarinetists and oboists can also develop a callus on the middle line of the upper lip

2. lip trauma

horn players can develop weight loss (atrophy) of the central upper lip due to the pressure of the mouthpiece against the lip that blocks the blood supply.

Wind and brass players can have Soft fabric trauma to the lips from the pressure of your instrument that pushes the lips against the sharp edges of the teeth and restorations. Such problematic edges can be smoothed or rounded by the dentist, or lip balms can be used.

3. metal allergy

Allergic contact dermatitis nickel and chromate have been reported as flute players, clarinet players, trumpeters, trumpeters and due to a nickel plated harmonica. In most cases, this presents as a cheilitis, except in flute players where a eczemaSimilar to the reaction it affects the chin just below the lower lip. Saliva and sweat between the skin / lip and the mouthpiece contribute to the release of metal from the mouthpiece and the development of allergy.

In a case report, the trumpeter's examination revealed climbing and crust of the central third of both lips. The trumpeter was able to replace his nickel mouthpiece with one made of gold, resulting in an improvement.

4. Cane allergy to cane

Reed allergy is reported in reed instrument players, mainly saxophonists and clarinet players. Immediate (type I) and delayed (type IV) reactions have been reported. Cheilitis affects the central lower lip, which appears as redness and / or peeling. Inflammation of the lip with associated itching of the tongue within a few minutes of exposure has been reported in immediate reactions.

Only the lower lip is involved in reed allergy due to a single reed woodwind instrument such as the clarinet or saxophone, as the reed is located on the underside of the mouthpiece.

The cane is made from Arundo donax, which belongs to the Gramineae family, Poaceae subfamily. Patch Tests and scratch / prick tests can be performed using fine shavings from a reed shank. In some cases, the reaction of the patch test (for Type IV) or the puncture test (for Type I) has only been positive with a new rod and in others only with a used one.

It has been suggested that the reaction is due to cross reactivity with Allergens causing grass pollen allergies.

Replacing the reed with a plastic one has resulted in rapid improvement in some cases. However, other musicians have not been satisfied with the resulting sound quality.

5. allergy to exotic wood

Allergic contact dermatitis to exotic woods used in the manufacture of wooden musical instruments has been reported. Allergic cheilitis has been observed in tape recorder players.

A recent case report described a recording player that filed a erosive cheilitis of the central third of the lower lip. The sawdust patch test (10% in Vaseline) of your wood engravers was performed with the removal of the patches after one day to minimize the risk of a irritating reaction. It had positive reactions to African blackwood (Dalbergia melanoxylon) and rosewood, the latter being a cross reaction. Puncture tests with sawdust (1% in water) were negative. The allergens in black wood and rosewood from Africa are quinones, (S) -49-methoxdalbergione and (S) -49-hydroxy-4-methoxdalbergione.

6. Thiuram allergy

A case has been reported of a trumpeter who became sensitized to tiuram after a temporary black henna tattoo and then reacted to the mouthpieces of his brass instruments stored in rubber-lined foam boxes. In the patch test, he also reacted to the rubber foam in his instrument case, which contained thiuram (a rubber accelerator). The problem was resolved by storing the nozzles separately.

7. The Pied Piper's Chin

The flutist's chin is described as acne eruption with more pigmentation on the chin where the flute rests. It is probably due to the combination of saliva, condensation of the breath and pressure of the flute against the skin.

8. Clarinetist's cheilitis.

Clarinetist cheilitis is usually a form of irritating contact dermatitis that affects half of the lower lip that extends from the vermilion margin to the chin. Probably due to the combination of moisture (saliva, sweat), pressure and friction.

9. black dermographism

Black discoloration of the lower lip / chin has been reported in a flute player due to an interaction between the flute silver and a sulfur / zinc containing lotion being used to treat perioral acne.