Acne Keloidalis Nuchae: A Therapeutic Challenge for Dermatologists

Acne keloidalis nuchae (AKN) is a chronic inflammatory dermatosis of the scalp that causes scarring alopecia. The etiology of AKN has been associated with an immune response vs. follicular antigens. AKN is characterized by fibrotic papules and plaques that can converge in tumor-like lesions; subclinical disease has been reported in perilesional areas, which could impact its development. Early diagnosis and treatment are essential to reduce morbidity and preserve and minimize healing. Various treatments have been established including optimal medical therapy, surgical excision, and light sources. An updated description of treatments (algorithm included) used for AKN is suggested based on the clinical lesions.