Acne Keloidalis Nuchae, also known as "folliculitis keloidalis" and "folliculitis nuchae," is a common chronic condition that causes inflammation and keloid-like scarring on the back of the neck. This condition is commonly confused with acne lesions or razor bumps. It most commonly occurs in black males between the ages of 14 and 25.
Cause
The etiology is not completely understood. Some theorize this may begin with chronic irritation or an injury related to a close haircut or use of a razor. Tightly curled hair types, obesity, and metabolic syndrome are also believed to play a role in the cause.
Clinical Features
Small, pruritic bumps on the occipital scalp. Scratching can lead to secondary infection and pustules. These bumps can progress into small scars and eventually form larger, keloid-like masses. Hair loss is commonly associated with these scars.
Complications
Complications can include secondary bacterial or fungal infections and associated hair loss.
Diagnosis
Diagnosis is often made clinically based on history of appearance; however, if the diagnosis is uncertain, a biopsy can be performed.
Treatment
Treatment options often include decreasing irritation or injury to the affected area, topical steroids, and steroid injections. Topical or oral antibiotics are often used to treat secondary infections. Surgery may be useful for removing larger lesions. In severe cases, laser hair removal or oral isotretinoin may be indicated.
Differential Diagnosis
This condition can resemble bacterial folliculitis, molluscum contagiosum, folliculitis decalvans, and dissecting cellulitis.
Citation: "Folliculitis Keloidalis." (n.d.). Retrieved from https://dermnetnz.org/topics/folliculitis-keloidalis.
"Acne Keloidalis Nuchae: Overview." (n.d.). Retrieved from https://www.aad.org/public/diseases/a-z/acne-keloidalis-nuchae-overview.
Written by Alexandra Jewell, PA
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