Hyperplasia
Acne Keloidalis Nuchae
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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
Papule
s and
Pustule
s on occiput and neck (each 2-4 mm)
Papule
s 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
Gene
ral Measures
Avoid tight fitting shirts that rub the occipital area
Avoid shaving or tightly clipping the occipital region
Initial medical management
High potency
Topical Corticosteroid
s (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]
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