“…He was successfully treated with low-dose radiation therapy, followed by excision of the residual lesions. 7 Figure 3 CVG and widespread AKN plaques and masses: patient 2 with CVG onset within two years of AKN starting in the nuchal area: left posterior oblique ( A ) and posterior ( B ) view of head showing widespread AKN and CVG. …”
Section: Resultsmentioning
confidence: 99%
“…He was successfully treated with low-dose radiation therapy, followed by excision of the residual lesions. 7 Patient 3…”
Purpose
Both acne keloidalis nuchae (AKN) and cutis verticis gyrata (CVG) are scalp conditions predominantly affecting men. Both are characterized by dermal thickening and fibroblast hyperactivity. AKN typically occurs in the nuchal area, often involving the naturally occurring folds in the occipital region. The aim of this study was to determine the relationship between excessive scalp folding (CVG) and AKN.
Patients and methods
A total of 108 patients with AKN seen over 11 years from July 2009 and November 2020 were retrospectively evaluated. Patients with AKN concomitant with CVG were selected for analysis.
Results
Seven of the 108 AKN patients had scalp-wide (widespread) AKN lesions, including 4 with CVG. In 3 of the 4 patients with concomitant AKN and CVG, the AKN was widespread, and its onset had preceded CVG by 1–2 years. In the fourth CVG patient, AKN lesions were confined to the nuchal area, and the CVG preceded AKN onset by several years. All patients were male, with a mean age of 35.8 years (overall) and 38.0 years (CVG group).
Conclusion
We describe a previously unreported relationship between widespread AKN and CVG, with the development of AKN preceding CVG formation.
“…He was successfully treated with low-dose radiation therapy, followed by excision of the residual lesions. 7 Figure 3 CVG and widespread AKN plaques and masses: patient 2 with CVG onset within two years of AKN starting in the nuchal area: left posterior oblique ( A ) and posterior ( B ) view of head showing widespread AKN and CVG. …”
Section: Resultsmentioning
confidence: 99%
“…He was successfully treated with low-dose radiation therapy, followed by excision of the residual lesions. 7 Patient 3…”
Purpose
Both acne keloidalis nuchae (AKN) and cutis verticis gyrata (CVG) are scalp conditions predominantly affecting men. Both are characterized by dermal thickening and fibroblast hyperactivity. AKN typically occurs in the nuchal area, often involving the naturally occurring folds in the occipital region. The aim of this study was to determine the relationship between excessive scalp folding (CVG) and AKN.
Patients and methods
A total of 108 patients with AKN seen over 11 years from July 2009 and November 2020 were retrospectively evaluated. Patients with AKN concomitant with CVG were selected for analysis.
Results
Seven of the 108 AKN patients had scalp-wide (widespread) AKN lesions, including 4 with CVG. In 3 of the 4 patients with concomitant AKN and CVG, the AKN was widespread, and its onset had preceded CVG by 1–2 years. In the fourth CVG patient, AKN lesions were confined to the nuchal area, and the CVG preceded AKN onset by several years. All patients were male, with a mean age of 35.8 years (overall) and 38.0 years (CVG group).
Conclusion
We describe a previously unreported relationship between widespread AKN and CVG, with the development of AKN preceding CVG formation.
“…Wide-ranging scalp disease distribution patterns, including a varying degree of nape zone affectation to more extensive scalp distribution and the presence or absence of other cicatricial scalp diseases, including folliculitis decalvans (FD), are also contributing factors. 1 , 2 , 3 , 4 Various studies have shown that laser hair removal can achieve long-term remission in papular AKN. 2 , 5 However, there are mitigating conditions that restrict the applicability or effectiveness of laser hair removal (LHR) in AKN treatment.…”
“…8 Similar to the procedure by Patra and colleagues for discrete peripheral lesions, punch excision followed by healing with secondary intention or extraction of central hair follicles in these papules by follicular unit extraction can be performed for smaller papular keloidal lesions. 5,9 Tumor stages, however, need aggressive approaches such as surgical excision, cryotherapy, or radiation treatment. Radiation therapy, although effective with no long-term recurrence, remains controversial whether the benefits of radiation therapy outweigh its risks to treat benign lesions in young adults.…”
mentioning
confidence: 99%
“…8 Similar to the procedure by Patra and colleagues for discrete peripheral lesions, punch excision followed by healing with secondary intention or extraction of central hair follicles in these papules by follicular unit extraction can be performed for smaller papular keloidal lesions. 5,9…”
Repeat surgery is occasionally required as was performed in one of the authors' case. Horizontal elliptical incision resulted in better wound healing and more natural appearing hairline as compared with nonelliptical incision. 5 There are no data from the Indian subcontinent and skin types 4 and 5, which have more tendency for hypertrophic scar.The authors found in their series that an elliptical excision with secondary-intention healing resulted in good wound healing, minimal postoperative discomfort, and very few recurrences. It may serve as an effective treatment modality in refractory cases of AKN.
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