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2026, Number 2

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Dermatología Cosmética, Médica y Quirúrgica 2026; 24 (2)

The fundamental role of surgery in the definitive treatment of acne keloidalis nuchae

Fernández CR, Morales MAY, Boeta ÁL

Language: Spanish
References: 33
Page: 315-320
PDF size: 384.05 Kb.


ABSTRACT

Keloid acne of the neck (KAN) is a rare condition that most frequently affects black men, followed by Hispanics, who are the second most affected group. It is located in the occipital region and the nape of the neck; it is mainly characterized by pustules and fibrotic plaques that can resemble a keloid scar and, sometimes, exophytic tumor-like masses. These lesions are accompanied by itching and pain. Being visible and disfiguring, they cause changes in body image and feelings of shame. Conventional treatment includes antibiotics, systemic retinoids, and intralesional steroids. These drugs reduce symptoms and inflammation, but the persistence of fibrous scars is the norm. Therefore, definitive treatment consists of removal by laser or surgical block resection of the affected areas. These alternatives provide a better quality of life for patients, although they are usually the least used. It is essential to consider these surgical options, in addition to conventional medical treatment.


REFERENCES

  1. Brahe C, Peters K, Meunier N. Acne keloidalis nuchae in thearmed forces. Cutis. 2020; 105(5):223-226.

  2. Ogunbiyi A. Acne keloidalis nuchae: prevalence, impact, andmanagement challenges. Clin Cosmet Investig Dermatol. 2016;9:483-489.

  3. Jiang C, Ting AT, Seed B. PPAR-g agonist inhibit production ofmonocyte inflammatory cytokines. Nature. 1998; 391: 82-86.

  4. Kridin K, Solomon A, Tzun-Bitan D, et al. Acne Keloidalis Nuchaeand the Metabolic Syndrome: A Population-Based Study. Am JClin Dermatol. 2020; 136(11):1376-9.

  5. Valdman-Grinshpoun Y, Kridin K, Schonmann Y, et al. Acnekeloidalis nuchae and thyroid diseases: a population-basedcohort study. Int J Dermatol. 2021; 60(4):466-470.

  6. Kridin K, Patel PM, Jones VA, et al. Hidradenitis suppurativais associated with acne keloidalis nuchae: a population-basedstudy. Arch Dermatol Res. 2021; 313(5):333-337.

  7. Saka B, Teclessou JN, Akakpo SA, et al. Acne keloidalis nuchaeand hypertension in black subjects: a case-control study. BMCRes Notes. 2020; 13(1):431.

  8. Metin SA, Parish LC. Acne Keloidalis Nuchae—Is the BarberReally to Blame? Skinmed. 2017; 15(4):247-249.

  9. Beckett N, Lawson C, Cohen G. Electrosurgical excision ofacne keloidalis nuchae with secondary intention healing. J ClinAesthet Dermatol. 2011; 4(1):36-9.

  10. Na K, Ho Oh S, Kim SK. Acne keloidalis nuchae in Asian: A singleinstitutional experience. PLoS One. 2017; 12(12):e0189790.

  11. Kwan JYY, Tsao M, Barnes E. Hypofractionated radiotherapy totreat acne keloidalis nuchae. CMAJ. 2021; 193(41):E1595.

  12. Verma SB, Wollina U. Acne keloidalis nuchae with acanthosisnigricans of the neck: The pivotal role of the dermatologist inthe early diagnosis of insulin resistance. Dermatol Ther. 2020;33(6):e14102.

  13. Maranda EL, Simmons BJ, Nguyen AH, et al. Treatmentof Acne Keloidalis Nuchae: A Systematic Review of theLiterature. Dermatol Ther (Heidelb). 2016; 6(3):363-78.

  14. Tawfik A, Osman MA, Rashwan I. A novel treatment of acnekeloidalis nuchae by long-pulsed alexandrite laser. DermatolSurg. 2018; 44(3):413-420.

  15. Haynes D, Topham C, Greiling T. Acne keloidalis nuchae andobstructive sleep apnoea: a retrospective case series. Clin ExpDermatol. 2019; 44(5):e214-e215.

  16. Galarza LI, Azae CA, Hmada YA, et al. Surgical management ofgiant acne keloidalis nuchae lesions. Case Reports Plast SurgHand Surg. 2021; 8(1):145-152.

  17. Salami T, Omeife H, Samuel S. Prevalence of acne keloidalisnuchae in Nigerians. Int J Dermatol. 2007; 46(5):482-4.

  18. Alexis A, Heath CR, Halder RH. Folliculitis keloidalis nuchae andpseudofolliculitis barbae: are prevention and effective treatmentwithin reach. J Clin Aesthet Dermatol. 2014; 7(2):18-21.

  19. Loayza E, Vanegas E, Cherrez A. Acne keloidalis nuchae in LatinAmerica: is there a different phenotype? Int J Dermatol. 2017;56(12):1469-1470.

  20. East-Innis ADC, Stylianou K, Paolino A, et al. Acne keloidalisnuchae: risk factors and associated disorders—a retrospectivestudy. Int J Dermatol. 2017; 56(8):828-832.

  21. Saka B, Akakpo AS, Téclessou JN, et al. Factores de riesgoasociados con acné queloideo de la nuca en sujetos de razanegra. Ann Dermatol Venereol. 2020; 147(5):350-354.

  22. Adegbidi H, Atadokpede F, do Ango-Padonou F, et al. Keloidacne of the neck: epidemiological studies over 10 years. Int JDermatol. 2005; 44 Suppl 1:49-50.

  23. Glenn MJ, Bennett RG, Kelly AP. Acne keloidalis nuchae:treatment with excision and second-intention healing. J AmAcad Dermatol. 1995; 33:243-6.

  24. Califano J, Miller S, Frodel J. Treatment of occipital acnekeloidalis by excision followed by secondary intentionhealing. Arch Facial Plast Surg. 1999; 1(4):308-11.

  25. Bajaj V, Langtry JA. Surgical excision of acne keloidalis nuchaewith secondary intention healing. Clin Exp Dermatol. 2008;33(1):53-5.

  26. Pestalardo CM, Cordero A Jr, Ansorena JM, et al. Acnekeloidalis nuchae. Tissue expansion treatment. Dermatol Surg.1995; 21(8):723-4.

  27. Gutierrez-Gómez C, Váldez-Diaz B. Tratamiento quirúrgico deacné queloide nucal. Cir Plast. 2020; 30(3):156-159.

  28. Gloster HM. The surgical management of extensive cases ofacne keloidalis nuchae. Arch Dermatol. 2000; 136(11):1376-9.

  29. Doche I, Coelho EQ, Quaresma MV, et al. Acne keloidalis nuchaeand folliculitis decalvans: same process affecting the follicle orcoexisting diseases? Int J Dermatol. 2019; 58(10):e200-e203.

  30. Labib A, Salfity L, Powell B. Acne Keloidalis Nuchae: A StagedReconstruction. Cureus. 2021; 13(9):e18173.

  31. Umar S, Sila CR. Acne keloidalis nuchae: A role for low-doseradiotherapy. JAAD Case Rep. 2021; 13:90-93.

  32. Umar S, Lullo J, Sila CR. Patient Selection Criteria andInnovative Techniques for Improving Outcome and Cosmesis inAcne Keloidalis Nuchae Lesion Excision and Primary Closure. JClin Aesthet Dermatol. 2021; 14(4):E61–E67.

  33. Ortiz-Lobato L, Imbernón-Moya A, Saceda-Corralo D, etal. Acne Keloidalis Nuchae: A Therapeutic Challenge forDermatologists. Actas Dermosifiliogr. 2025; 116(4):T394-T402.




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