Sir, dermatoses in musicians can occur in players of brass, percussion, wind instruments and also players of string instruments.1 We present a 36-year-old woman (Fig. 1) who plays the violin with an irritant area from contact of the chin rest with the left submandibular neck who came for routine dental examination. Cutaneous examination of the left submandibular neck demonstrated a hyperpigmented, erythematous plaque. A panoramic radiograph showed some calcifications and one of them is an oval calcification with smooth periphery and has the appearance of laminations, giving it a bull's-eye or targetoid appearance in the internal aspect like phlebolith.

Figure 1
figure 1

a) Touchpoint of violin on left submandibular area; b) Irritant area from contact of the violin; c) Targetoid shaped oval calcification on panoramic image (white arrow), other small calcifications (white arrowheads)

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One of the most common types of trauma-induced dermatitis in musicians is fiddler's neck syndrome, induced by violins and violas. There is greater variety of clinical aspects in this syndrome than in the usual irritant contact dermatitis. The lesions can be localised plaques of erythema, sometimes pigmented or lichenified.2 However, these lesions are generally not considered radiographically and the direct relationship between the violin and phlebolith-like calcification has never before been recorded in medical literature. In some literature violin pressure points have been shown to be among the causes of dystrophic calcification.3

We evaluated this calcification seen in the neck as phlebolith from an acquired vascular malformation or a dystrophic calcification. An increase in the number of cases like this would help us to understand this condition more clearly.