Acne keloidalis nuchae (AKN) represent a chronic deep-seated scarring folliculitis that predominantly involves the nape, but other anatomical regions of the scalp might be implicated as well. It is more commonly observed in dark-skinned male patients, and women are less frequently affected. 1 The disease is considerably less frequent in other ethnic populations. 2,3 AKN is characterized clinically by large, indurated papules, pustules, and nodules coalescing into keloid-like plaques, hence the name. Histologically, it is represented as a deep inflammatory lesion in the mid-lower dermis with naked hair shafts. Treatment is challenging and relies on topical and intralesional corticosteroids in combination with systemic antibiotics for the inflammatory lesions and on surgical therapy or laser for the keloidal component of the disease. 4,5