ABSTRACT
Acne keloidalis nuchae (AKN), also known as Folliculitis keloidalis nuchae, is a primary scarring alopecia, characterized by chronic follicular papules mainly on the occipital scalp and neck that evolve into keloid-like scars. AKN is a disease of young men of African American or Hispanic descent. The exact etiology of AKN is unknown, and it is believed to be multifactorial. The leading mechanisms in the pathogenesis of AKN are follicular trauma and aberrant immune response. The diagnosis of AKN is based on the clinical findings. The onset of disease is usually after puberty. Histologically AKN is considered a primary neutrophilic cicatricial alopecia. Laser treatments with long-pulsed 1064-nm Nd: YAG laser, 810-nm diode laser, 755-nm Alexandrite laser, and 595-nm PDL have been reported to significantly reduce the count and size of lesions, with lasting results at follow-ups. Radiotherapy led to complete resolution of AKN lesions in a refractory unresponsive patient with excellent cosmetic results and lack of recurrence.
