Tumor Stage Acne Keloidalis Nuchae Treated with Surgical Excision and Secondary Intention Healing

April 2012 | Volume 11 | Issue 4 | Feature | 540 | Copyright © 2012

Abstract

No abstract available

Purchase Original Article

Purchase a single fully formatted PDF of the original manuscript as it was published in the JDD.

Download the original manuscript as it was published in the JDD.

Contact a member of the JDD Sales Team to request a quote or purchase bulk reprints, e-prints or international translation requests.

To get access to JDD's full-text articles and archives, upgrade here.

Save an unformatted copy of this article for on-screen viewing.

Print the full-text of article as it appears on the JDD site.

→ proceed | ↑ close

INTRODUCTION

An African-American male, aged 44 years, presented with an enlarging, painful, and pruritic mass on his scalp possibly triggered by a "close haircut." He had failed to respond to intralesional corticosteroids. On examination, a multi-nodular, keloidal mass extended from the central occipital scalp to the right temporal scalp (Figure 1, Figure 2). After discussing treatment options with the patient, he was scheduled for excision.

The site was cleansed and anesthetized via local anesthesia. The keloidal tissue was excised. Care was taken to extend the depth of the excision down to normal-appearing subcutaneous fat just below the level any visible follicular structures. Bleeding was cauterized. The wound was covered with petrolatum, followed by Telfa non-stick pads, and then covered by sterile gauze.

Five weeks later, a few papules were noted peripherally at the completely healed excision site; these papules were injected with triamcinolone. The patient was given doxycycline 100 mg to be taken twice daily for 30 days and fluocinonide ointment to be applied twice daily to any raised papules.

Seven months after surgery, the patient noted complete sat- isfaction with the outcome of the procedure. On physical examination, a supple, slightly depressed patch was noted at the excision site (Figure 3, Figure 4).

DISCUSSION

AKN is an idiopathic, scarring folliculitis of the occipital scalp and nape of the neck that affects post-pubertal African-American men. Early lesions are often treated with topical or intralesional corticosteroids and tetracycline class antibiotics.1 For large plaque and tumor stage AKN, surgical excision may be the treatment of choice. Recurrences are more likely if the

table 1

↑ back to top


  • 1
  • 2

Related Articles