This term covers a mixed group of disorders in which the acne occurs at the site of physical trauma, as indicated by the pattern of the lesions. Examples are so-called fiddler's neck, which occurs on the neck of violin players, and is also characterized by the presence of lichenification and pigmentation. Headbands (as worn by sports-people and hippies) and tight bra straps are other causes. Continuous friction from turtle-neck sweaters may localize acne to the neck. Adolescent patients lying in bed for a long time, for example following a fractured femur in the orthopaedic ward, may develop a flare of acne-the so-called 'immobility acne'. This is probably due to a change in the environment of the skin, which may enhance bacterial colonization of the duct.
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