Electrosurgical excision and loop cautery of acne keloidalis nuchae: alternatives to standard surgical excision

Acne keloidalis nuchae (AKN) is a scarring folliculitis characterized by papules, pustules, and tumor-like masses on the neck and scalp. Management varies with severity; mild cases respond to topical treatments, while severe cases may require systemic therapies or surgical interventions. We present two tumor-stage AKN cases successfully treated with electrosurgical excision and loop cautery, followed by secondary intention healing. In Case 1, a 38-year-old male with extensive keloidal plaques achieved significant improvement after electrosurgical excision. In Case 2, a 19-year-old male with recurrent pustules saw notable cosmetic and symptomatic relief from loop cautery. Both techniques proved effective and enhanced healing.