Treatment of acne keloidalis nuchae with carbon dioxide laser

The Surgical Management of Extensive Cases of Acne Keloidalis Nuchae

“…8,[11][12][13] The late lesions of AKN, with draining sinuses and large, keloidal masses, are often refractory to treatment, including therapy with topical and intralesional steroids, 5,8,12 topical and oral antibiotics, retinoids, 10,16 and irradiation. 5,6,10,14,17 Surgical approaches to late-stage AKN include epilation, 5,8,12,14 excision with second-intention healing, 10,13,16 excision with primary closure, 5,14,16,18 and excision with grafting. 5,12,14,16,17,19 The purpose of this study was to determine the efficacy of excision with primary closure in the treatment of 25 patients with extensive and refractory AKN.…”

“…5,6,10,14,17 Surgical approaches to late-stage AKN include epilation, 5,8,12,14 excision with second-intention healing, 10,13,16 excision with primary closure, 5,14,16,18 and excision with grafting. 5,12,14,16,17,19 The purpose of this study was to determine the efficacy of excision with primary closure in the treatment of 25 patients with extensive and refractory AKN.…”

“…Recurrences are more likely to occur if the surgeon fails to achieve subfollicular destruction during surgical excision. 10,13,16 Thus, the excision must extend to the deep subcutaneous tissue or muscular fascia, since hair follicles typically penetrate the subcutaneous fat.…”

“…13 Excision with subsequent split-thickness skin grafting has also been described in the treatment of AKN. 5,12,14,16,17,19 Unfortunately, the cosmetic benefits of skin grafting are limited. 15,16,18 Split-thickness skin grafts are often atrophic, smooth, and shiny, and do not match surrounding skin in color, texture, or thickness.…”

“…5,12,14,16,17,19 Unfortunately, the cosmetic benefits of skin grafting are limited. 15,16,18 Split-thickness skin grafts are often atrophic, smooth, and shiny, and do not match surrounding skin in color, texture, or thickness. Furthermore, the graft sites are significantly depressed below the level of the surrounding skin.…”