Surgical Treatment of Scarring Alopecia Associated with Acne Keloidalis Nuchae

Keiichi Tamagawa,Daichi Morioka,Rikako Suminaga,Ayako Aoki,Yuka Shibuya,Hiroki Utsunomiya,Zhuo Zhang

doi:10.4236/mps.2019.91003

Abstract

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.

Highlights

Acne keloidalis nuchae (AKN) is a relatively rare chronic inflammatory condition that leads to alopecia on the occipital scalp
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
Acne keloidalis nuchae (AKN) is an idiopathic chronic inflammatory condition characterized by the formation of papules and pustules that develop into keloid-like masses on the occiput and nape of the neck [1] [2]

Summary

Introduction

Acne keloidalis nuchae (AKN) is an idiopathic chronic inflammatory condition characterized by the formation of papules and pustules that 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]. We present a case of a Japanese male patient with scarring alopecia associated with AKN that was successfully treated with local flap reconstruction following total excision of the lesion

Case Report

Discussion