Treatment of Acne Keloidalis Nuchae: A Systematic Review of the Literature

Maranda, Eric L.; Simmons, Brian J.; Nguyen, Austin Huy; Lim, Victoria M.; Keri, Jonette

doi:10.1007/s13555-016-0134-5

Cited by 60 publications

(50 citation statements)

References 31 publications

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“…The 1064 nm Nd: YAG destroys the hair follicles within the lesions which has some bearing on the inflammation 38. It can be used in conjunction with topical steroids or retinoids and has been found useful in refractory cases.…”

Section: Clinical Featuresmentioning

confidence: 99%

Acne keloidalis nuchae: prevalence, impact, and management challenges

Ogunbiyi¹

2016

CCID

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Acne keloidalis nuchae (AKN) also known as folliculitis keloidalis nuchae (FKN) is a chronic form of scarring folliculitis seen mostly in men of African descent. The term AKN is commonly used even though the condition is not a keloid, and the affected individuals do not have a tendency to develop keloids in other areas of the body. It is seen in post pubertal men and is rare after the age of 55 years. A few cases have been reported in females. which has been classified as a primary cicatricial alopecia since the exact cause of acne keloidalis (AK) remains unknown. However, a few inciting agents have been suggested which include androgens, inflammation, infection, trauma, genetics, and ingrowing hairs. AK shares some similar features with other forms of cicatricial alopecia and may occur together. Papules, pustules, and sometimes tumorous masses in the nuchal or occipital regions of the scalp hence the name “bumps” evolved in the environment. Despite its common occurrence, only a few seek help in hospital when lesions start to unsightly affect the individual’s quality of life. The presences of the keloidal lesions are more stressful compared to the resulting alopecia. Various attempts to reduce the bumps with corrosives, acids, and car engine oils lead to larger lesions or unsightly scars. Active lesions produce bleeding during haircuts. This is worrisome as a couple of individuals with active AK share shaving instruments at the barber shop and are at risk of acquiring or transmitting blood-borne infections. There is an urgent need to encourage safe shaving habits and treatment of lesions at onset so as to prevent unsightly lesions.

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Section: Clinical Featuresmentioning

confidence: 99%

Acne keloidalis nuchae: prevalence, impact, and management challenges

Ogunbiyi¹

2016

CCID

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“…Pestalardo et al [8] reported total excision using a tissue expander. Both authors demonstrated excellent outcomes for the treatment of AKN-associated alopecia, but both maneuvers required multistage surgery [1] [6] [8]. Although long scars might re-…”

Section: Discussionmentioning

confidence: 99%

“…Acne keloidalis nuchae (AKN) is an idiopathic chronic inflammatory condition characterized by the formation of papules and pustules that ultimately develop into keloid-like masses on the occiput and nape of the neck [1] [2]. This hyperproliferative disorder typically occurs in young adult males of African origin [2] [3], but it is relatively rare in the Asian population [4].…”

Section: Introductionmentioning

confidence: 99%

“…The relapsing condition leads to sparse hair or multiple large keloids on the occipital scalp [1] [3]. Scarring alopecia that has resulted from long-lasting folli-culitis cannot be cured by conservative treatment, and impairs the psychosocial functioning and self-esteem of patients [3].…”

Section: Introductionmentioning

confidence: 99%

“…Scarring alopecia that has resulted from long-lasting folli-culitis cannot be cured by conservative treatment, and impairs the psychosocial functioning and self-esteem of patients [3]. Although many authors have reported the effectiveness of nonsurgical and surgical treatments, such treatments attempt to prevent the recurrence of this inflammatory condition; very few reports have focused on the treatment of the alopecia associated with AKN [1].…”

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Scarring Alopecia Associated with Acne Keloidalis Nuchae

Tamagawa¹,

Morioka²,

Rikako³

et al. 2019

MPS

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Acne keloidalis nuchae (AKN) is a relatively rare chronic inflammatory condition that leads to alopecia on the occipital scalp. Multiple large keloids and alopecia associated with long-lasting folliculitis impair the psychosocial functioning of patients. We report successful treatment of alopecia associated with AKN. When a 23-year-old male was referred to us, a large area of alopecia and multiple keloids associated with AKN were found. Following total excision of the lesion, the defect was reconstructed with two rotation flaps elevated bilaterally. Most patients with AKN undergo conservative treatments including oral antibiotics and local steroid injections. As surgical treatments, excision followed by skin grafting or second-intention healing has been reported. However, all of the previously-reported treatments have left alopecia on the occipital region. Although long scars might be left in the scalp, local flap reconstruction would be an option for the treatment of large areas of alopecia associated with AKN.

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