Serial punch excisions followed by second-intention healing for acne keloidalis papules

Papular acne keloidalis nuchae treatment success using follicular unit excision

“…A previous report described large skin biopsy punches (3 mm and greater) in excising AKN lesions and tufted hairs in a series of 6 treatments. 10 However, large punches would cause large circular scars, which would not be suitable for mild AKN cases where the threshold for acceptable scarring is low compared to severe AKN plaques. Furthermore, targeting scattered, tufted hairs in AKN are not likely to result in long-term remission because the few tufted follicles in the AKN plaque do not account for most of the diseased zone, where only a few hairs are visible candidates for punching out.…”