Acne keloidalis nuchae

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Acne keloidalis nuchae
Acne keloidalis nuchae on the back of the neck
Synonyms Folliculitis keloidalis, acne keloidalis, dermatitis papillaris capillitii
Pronounce N/A
Specialty Dermatology
Symptoms Papules, pustules, keloids on the nape of the neck
Complications Scarring, alopecia
Onset Adolescence or early adulthood
Duration Chronic
Types N/A
Causes Unknown, possibly mechanical irritation or genetic predisposition
Risks Tight clothing, short haircuts, African descent
Diagnosis Clinical examination, biopsy
Differential diagnosis Acne vulgaris, pseudofolliculitis barbae, hidradenitis suppurativa
Prevention N/A
Treatment Topical corticosteroids, antibiotics, laser therapy, surgical excision
Medication N/A
Prognosis N/A
Frequency More common in males of African descent
Deaths N/A


== Acne Keloidalis Nuchae ==
Acne Keloidalis Nuchae on the nape of the neck

Acne Keloidalis Nuchae (AKN) is a chronic inflammatory condition that primarily affects the nape of the neck. It is characterized by the formation of papules, pustules, and keloid-like scars. This condition is most commonly seen in individuals with curly hair, particularly those of African descent.

Pathophysiology

The exact cause of Acne Keloidalis Nuchae is not fully understood, but it is believed to be related to folliculitis, which is the inflammation of hair follicles. The condition begins with small, itchy papules that can progress to pustules and eventually form keloid-like scars. These scars are firm, raised, and can be disfiguring.

Clinical Presentation

Patients with Acne Keloidalis Nuchae typically present with:

  • Small, itchy papules on the nape of the neck
  • Progression to pustules and nodules
  • Formation of keloid-like scars
  • Possible secondary infection

The lesions are often painful and can lead to significant cosmetic concerns for the patient.

Diagnosis

Diagnosis of Acne Keloidalis Nuchae is primarily clinical, based on the characteristic appearance of the lesions. A skin biopsy may be performed to rule out other conditions such as pseudofolliculitis barbae or hidradenitis suppurativa.

Treatment

Treatment options for Acne Keloidalis Nuchae include:

  • Topical and oral antibiotics to reduce inflammation and infection
  • Topical corticosteroids to decrease inflammation
  • Intralesional steroid injections for keloid-like scars
  • Laser therapy to reduce scar tissue
  • Surgical excision in severe cases

Patients are also advised to avoid close shaving and to use gentle hair care practices to prevent exacerbation of the condition.

Prognosis

The prognosis for Acne Keloidalis Nuchae varies. While some patients may experience improvement with treatment, others may have persistent or recurrent lesions. Early intervention and adherence to treatment can improve outcomes.

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Contributors: Prab R. Tumpati, MD