ABSTRACT
Acne keloidalis nuchae (AKN) is a chronic inflammatory condition that almost exclusively affects the occipital and nape areas. Although not completely understood, its etiopathogenesis seems to be multifactorial, including association with metabolic syndrome (MetS). Despite being commonly seen in patients with MetS, obesity per se as a possible related factor for AKN has yet to be studied. The aim of this study was to evaluate the relationship between obesity and AKN in a series of patients. Eight male patients, with a median age of 38 years (range 15-48), were included. Overweight/obesity was found in 8/8 (100%), with median BMI of 32.2 (range 27.7-43.85 kg/m2), including 2 patients with class 3 obesity. We hypothesize adipose tissue accumulation in the nape, the only moving part of the scalp, leads to redundant skin folds, more friction, and inflammation, triggering AKN. This paper highlights the possible relationship between AKN and overweight/obesity, hypothesizing a mechanism for their contribution to the etiopathogenesis of this scalp disorder. To the best of our knowledge, this is the first study focused specifically in this association. While general physicians should pay attention to the appearing of AKN in overweight/obese patients, dermatologists must be aware that AKN patients should be assessed beyond the skin.
ABSTRACT
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.