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Acne Keloidalis Nuchae
Aka: Acne Keloidalis Nuchae
- See Also
- Skin of Color
- Folliculitis
- Keloid
- Pathophysiology
- Idiopathic
- May be secondary to localized forreign body reaction to hair (similar to Pseudofolliculitis Barbae)
- Epidemiology
- Most common in black men
- Also occurs in hispanic, asian andwhite men
- Onset after Puberty and typically not after age 50 years
- Symptoms
- Variable pain and Pruritus
- Signs
- Papules and Pustules on occiput and neck (each 2-4 mm)
- Papules and coalesce into Keloid-like mass in band-shape on the occipital scalp and posterior neck
- Alopecia occurs in involved region
- Complications
- Subcutaneous abscess with draining sinus
- Scarring Alopecia in involved area
- Management
- General Measures
- Avoid tight fitting shirts that rub the occipital area
- Avoid shaving or tightly clipping the occipital region
- Initial medical management
- High potency Topical Corticosteroids (e.g. Clobetasol, Betamethasone)
- Topical Antibiotics (e.g. Clindamycin)
- Additional medical management
- Oral antibiotics
- Retin A
- Imiquimod (Aldara)
- Accutane
- Surgical excision
- References
- Kundu (2013) Am Fam Physician 87(12): 859-65 [PubMed]