Acné queloideo de la nuca: excelente respuesta al tratamiento con imiquimod 5% / Keloid acne of the nape: excellent response to treatment with imiquimod 5%

El acné queloideo de la nuca (AKN) o foliculitis esclerosante es un proceso inflamatorio crónico del folículo piloso en la región de la nuca. Su incidencia es baja y su etiología desconocida. Afecta con mayor frecuencia a hombres de mediana edad y de raza negra. A lo largo del tiempo se han utilizado diferentes modalidades terapéuticas con resultados variables. Presentamos el caso de un paciente con AKN que mostró una excelente respuesta al uso diario de imiquimod 5% tópico durante ocho semanas

Keloid acne of the neck (AKN) or sclerosing folliculitis of the nape of the neck is a chronic inflammatory process of the nape region. Its incidence is low and its etiology is unknown. It mainly affects brown-black males in middle age. Different treatment modalities have been used with different responses. We present the case of a patient with AKN who presented an excellent response to the daily use of topical imiquimod 5% for eight weeks

Two Cases of Acne Keloidalis Nuchae Developed in Patients with Metabolic Syndrome / 대한피부과학회지

No abstract available.

Extirpación quirúrgica con cierre primario y uso de Isotretinoína en acné queloídeo de la nuca: serie de 6 casos clínicos / Acne keloidalis nuchae

El Acné queloídeo de la nuca se presenta principalmente en hombres jóvenes de raza negra; su etiología es desconocida, pero se piensa que sería multifactorial. El cuadro clínico corresponde a pápulas y pústulas que tienden a confluir en placas de aspecto queloídeo y que se observan como alopecia cicatricial, produciendo gran repercusión tanto física como psicológica en el paciente. Histológicamente se distingue una etapa temprana y una avanzada. No existe tratamiento curativo para este cuadro, pero se ha experimentado con múltiples opciones de tratamiento. En este trabajo se exponen los resultados de nuestra experiencia terapéutica con cirugía excisional asociada a cierre primario y posterior uso de Isotretinoína oral.

The Acne keloidalis nuchae occurs mainly in young black men; its etiology is unknown but is thought to be multifactorial. Clinically it presents as papules and pustules which tend to coalesce in keloid-like plaques and they are observed as scarring alopecia, producing great impact both physically and psychologically in the patient. An early and an advanced stage can be distinguished with histological techniques. There is no cure for this pathology, even though multiple treatments have been tried. In this paper, we expose the results of our therapeutic experience with excisional surgery associated with primary closure and subsequent use of oral Isotretinoin.

Queloide: Uma Revisão dos TratamentosAtualmente Disponíveis / Keloids: A Review of the Currently Available Treatments

A formação de cicatrizes consiste no processo fisiológicode resposta a lesões e traumas a pele, alterações no processo decicatrização podem desencadear a formação de cicatrizes hipertróficase queloidianas. O queloide pode ser definido como um tumor benigno,correspondente a um excesso na produção de colágeno, levando acomplicações estéticas e físicas. Geralmente ocorrem após lesõesna pele, porém a ocorrência espontânea de queloide já foi relatada.Os principais sintomas dos queloides são dor, prurido e desconfortoestético. Muitas vezes o desconforto estético causado pelos queloidespode levar o paciente a demonstrar sintomas psicológicos e atémesmo atrapalhar seu convívio social. A etiologia do queloide não étotalmente compreendida, sua incidência demonstra ser maior emnegros e orientais, sua fisiopatologia é baseada em um aumento naproliferação de fibroblastos. Regiões do corpo como tórax, lóbulosauriculares e ombros, são mais propícias ao desenvolvimento dequeloides. Locais como pálpebras, escroto, regiões plantares e palmaressão consideradas raras em relação à incidência de queloides. Materiaise Métodos: Foram realizadas pesquisas em base de dados referentesa terapêutica de cicatrizes queloidianas e identificados os principaismétodos atualmente utilizados. Resultados: O tratamento de cicatrizesqueloidianas se apresenta complexo e de difícil resolução, entre asopções para o tratamento estão, tratamento cirúrgico, utilização decorticoides intralesionais, crioterapia, radioterapia, utilização de laser,produtos à base de silicone, pressoterapia, utilização de 5 fluorouracil,entre outros. A combinação entre alguns métodos é utilizada na práticaclínica com aumento de eficácia, porém nenhum método é totalmenteeficaz. Conclusão: Novos estudos se fazem necessário, tanto paramelhorar a compreensão fisiopatológica da doença como para amelhoria na terapêutica atualmente praticada...

Introduction: The scarring process is the physiological response toinjury and trauma to the skin. Changes in the healing process cantrigger the formation of hypertrophic and keloid scars. Keloid can bedefined as a benign tumor, corresponding to an excess in the productionof collagen, leading to aesthetic and physical complications. Althoughit usually occurs after skin injury, the occurrence of spontaneouskeloids has also been reported. The main symptoms of keloids arepain, itching and aesthetic discomfort. Such aesthetic discomfortcaused by keloids may often lead the individuals to demonstratepsychological symptoms and even disrupt their social life. The etiologyof keloids is not fully understood, with a higher incidence in blacksand Orientals. Its pathophysiology is based on an increase in fibroblastproliferation. Regions of the body such as the chest, shoulders andearlobes are more prone to developing keloids. Places such as eyelids,scrotum, plantar and palmar regions are less likely to develop keloids.Materials and Methods: Searches were conducted on databasesaddressing keloid therapy and the main treatment methods currentlyused were identified. Results: The treatment of keloid scars is complexand difficult; among the options for treatment are: surgical treatment,use of intralesional corticosteroids, cryotherapy, radiotherapy, use oflaser, silicon-based products, pressure therapy, use of 5-fluorouracil,among others. The combination of several methods is used in clinicalpractice with increased efficacy, but no method is completely effective.Conclusion: New studies are needed to improve the pathophysiologicalunderstanding of the disease as well as to increase the therapeuticalternatives currently employed...

Acné fulminans: presentación de un caso / Acne fulminans: case review

Introducción: El acné fulminans fué descrito en 1959 y se considera una forma aguda y grave de acné, originalmente se denominó como acné colglobata ulcerativo febril agudo, la principal característica es el inicio súbito de las lesiones. Los hayazgos clínicos incluyen acné ulcero-costroso, fiebre, poliartritis, anormalidades en las pruebas de laboratorio y escasa respuesta al tratamiento antimicrobiano. afecta principalmente a adolescentes varones, pero tambien puede presentarse en mujeres; las lesiones son mas frecuentes en tórax y se han reportado pocos casos de localización facial o ambos. El tratamiento de elección son los corticoides orales y la isotretinoína oral. Presentación de caso: Se trata de paciente femenino de 19 años de edad que debuta súbitamente con placas costrosas supurativas, nódulos y quistes que forman trayectos localizados en cara. Acompañando al cuadro fiebre, mal estado general y altralgias; ademas con leucocitosis y aumento de la velocidad de eritrosedimentación. Se manejo con antibióticos sistémicos, esteroides y posteriormente con isotretinoína oral, con resolución del cuadro. Conclusión: El acné fulminans es una entidad poco frecuente, su diagnostico es fundamentalmente clínico y su manejo debe ser oportuno para evitar secuelas. Esta rara enfermedad responde pobremente a los antibióticos de amplio espectro, a los antiinflamatorios no esteroideos y al tratamiento tópico convencional del acné vulgar. El tratamiento de elección son los corticosteroides orales y la isotretinoína, lo cual demostramos con la presentación de este caso clínico...

Actualización: manejo racional del acné / Updated: rational management of acne

El presente artículo tiene como objetivo dar a conocer, las recomendaciones que fueron dadas por la Alianza Global del tratamienton del acné, en el año 2003.Asimismo, en la parte final se mencionan las nuevas drogas que se han desarrollado en los últimos años, y el posible impacto que tendrá en las próximas determinaciones de la alianza global.

Acne keloidalis nuchae in a white woman

Acne keloidalis is a chronic inflammatory process that involves hair follicles of the nape of the neck and leads to hypertrophic scarring. In all references, it is noticed that this process occurs only in males after puberty and is especially seen in the black race. In this case, we report a 31-year-old white woman who had hypertrophic papules in the nape of her neck since 10 years ago and in pathological examination, the diagnosis of acne keloidalis was confirmed

Dermatological disorders related to cultural practices in black africans of Sierra Leone

To describe various skin manifestations directly or indirectly related to the prevalent cultural practices in the local community of black Africans of Sierra Leone. Eastern province [Kenema] of Sierra Leone from November 2004 to October 2005. Local black patients of all age groups presenting in Dermatology Outpatient department of Pak Field Hospital [established as a part of UN peacekeeping mission in Sierra Leone] were included. After clinical history and physical examination, lesions were photographed. Laboratory investigations were carried out when indicated. Skin diseases were broadly classified into two major categories i.e. related to cultural practices and not related to cultural practices. Non-black settlers in the area and UN troops were excluded. Data was recorded and analyzed by Microsoft Excel. A total of 3011 patients belonging to different local tribes having a variety of skin disorders were seen during the study period. Patients ranged from 1 month to 73 years of age with almost equal gender ratio. Vast majority were from very low socioeconomic group. Skin manifestations related to cultural practices were seen in more than 20% patients and most prevalent were alopecia and hypertrophic scars followed by pomade acne, pseudofolliculitis and contact dermatitis. Prevalent cultural practices in black Africans do play a role in causation of various skin disorders. For a dermatologist, it becomes imperative to be cognizant of the signs and symptoms associated with these practices for proper diagnosis and appropriate treatment

Descriptive study of primary cicatricial alopecia in patients referred to the skin clinic of Sina hospital in Tabriz- [1997-2004]

Cicatrical alopecia refers to lesions associated with permanent destruction of hair follicles. Several diseases such as folliculitis decalvans, lichenplanopilaris [LPP] and discoid lupus erythematosus [DLE] may result in cicatricial alopecia. Since cicatricial alopecia is scarring and affects both the appearance and psychosocial behaviours of the patients and also it can be an alarming sign of some systemic diseases, making an early diagnosis and proper treatment can prevent progression and further complications. The aim of this study was to determine the epidemiologic and clinicopathologic characteristics of cicatricial alopecia. A total of 100 patients with cicatricial alopecia were selected from those referred to the skin clinic of Sina hospital in Tabriz for further assessment from 1997 to 2004. Their disease was pathologically proven. All epidermiologic and clinicopathologic data were obtained through questionnaires. The results were analysed by means of descriptive statistical methods. Fifty-two of hundred patients were male and 48 were female. The highest incidence rate was found in 3[rd], 4[th] and 5[th] decades of life. The underlying diseases in descending order were: 30% [24 male, 6 female] had folliculitis decalvans, 25% [10 male and 15 female] had DLE, 18 [6 male, 12 female] pseudopelade of Brocq, 14% [4 male and 10 female] had LPP, 8% [4 male, 4 female] had morphea and 5 [4 male, 1 female] had keloidalis folliculitis. From a histo-pathologic point of view, lymphocytic cicatricial alopecia was more common among middle aged women [65%] whereas the neutrophilic type was more prevalent among middle aged men [35%]. The ratio of lymphocytic to neutrophilic cicatricial alopecias was 2/1. Considering the high incidence of cicatricial alopecia, early stage diagnosis by biopsy and proper treatment will reduce further progression and especially alleviate psychosocial disturbances

Efficacy of diode laser for treating acne keloidalis nuchae.

Acne keloidalis nuchae is usually treated with oral antibiotics, local antiseptics or intralesional steroids but with limited success. I assessed the efficacy of diode laser for treating the inflammatory and keloidal papules of acne keloidalis nuchae in two cases. The lesions in both the cases showed about 90 to 95% clearance after 4 treatment sessions at one to one and half month intervals. No new lesions were observed during the follow up period of six months after the last laser treatment. Thus, after clearing bacterial infection, laser hair epilation can be used as the first line of therapy for treating papules of acne keloidalis nuchae. This is the first attempt at treating acne keloidalis nuchae with a diode laser.

A case of acne keloidalis nuchae treated by surgical excision / 대한피부과학회지

A 43-year-old man presented with well-defined purple to skin-colored 2X1cm sized plague and various sized papules on the posterior neck. Histopathological findings were follicular and perifollicular inflammation with plasma cells, lymphocytes and neutrophils and dermal fibrosis shown as hypertrophic scar tissue. The patient was diagnosed as acne keloidalis nuchae and treated by surgical excision. We report a case of acne keloidalis nuchae showing typical clinical and histopathological findings.

Radiofrecuencia en dermatología: ventajas y desventajas / Radiofrequence in dermatology: advantages and disadvantages

La radiocirugía ha sido integrada fundamentalmente a todas las prácticas dermatológicas. El procedimiento es rápido, los resultados cosméticos en el postoperatorio son muy superiores, se obtiene una menor incomodidad para el paciente, una curación más rápida, menor infección y excelentes muestras histopatológicas. Por lo tanto, los médicos deben interesarse en continuar desarrollando esta valiosa y variada modalidad

Three Cases of Acne Keloidalis Nuchae / 대한피부과학회지

We report three cases of acne keloidalis nuchae which showing typical clinical and histopathological findings. A 61-year-old man showed well-defined child-fist sized erythematous to skin-colored hard plaque on his posterior scalp since two years ago and was treated by surgical excision and skin graft(STSG). A 22-year-old man showed discrete pinkish to erythematous pea sized follicular papules and pustules on his occiput since seven years ago and was treated by intralesional injection of triamcinolone for several times with fair response. Finally, a 38-year-old black man showed variable sized hard round follicular papules on his posterior scalp with several grouped hairs on the center of papules and was treated by intralesional injection of triamcinolone effectively. Histopathologically, common findings were follicular and perifollicular inflammation with the infiltration of plasma cells, neutrophils, lymphohistiocytes, massive dermal fibrosis resembling scar tissue, and diminished sebaceous glands.

Folliculitis Keloidalis Developed on the Thigh / 대한피부과학회지

A 24 year old man presented a large keloidal patch on the posterior thigh with persistent purulent fistulae and comedones on it. Histopathological findings showed folliculoperifolliculitis with polymorphs, lymphocytes, plasma cells, multinucleated giant cells and hypertrophic sclerotic connective tiasue. Clinically and histopathologically the diasgnoais of folliculitis keloidalis was made, which is known to develop mostly on the posterior neck. The lesion was treated by surgical excision and skin graft.