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INTRODUCTION: Acne keloidalis nuchae (AKN) is a primary cicatricial alopecia with mixed infiltrate. It is more common in Africans or persons of African descent. OBJECTIVES: Our objective was to describe the epidemiology and clinical and trichoscopic presentations of AKN in a large series of Hispanic patients. METHODS: This was a retrospective study from 10 different dermatological centers in Argentina, Colombia, Mexico, and Peru. Patients with a clinical diagnosis of AKN treated by 12 dermatologists experienced in trichology from 2018 to 2022 were included. The Umar classification system was used to determine severity. RESULTS: We identified 142 patients with AKN: 98% were male (n=140) with a mean age of 32 years; 108 patients had a previous history of trauma to the nuchal area (76%, P < 0.001); and 48 were positive for a history of acne (33.8%, P = 0.021). Patients with >50 months of evolution were mainly classified in classes III and IV compared to patients with an evolution of <50 months (30%, n=9 vs. 14%, n=15; P = 0.019; respectively). CONCLUSION: AKN should be considered in the differential diagnosis in the Hispanic population. Advanced stages of the disease are correlated with chronic evolution.
RESUMO
Trichotillomania is the most frequent reported cause of self-inflicted hair disorders, within which are included trichoteiromania, trichotemnomania, and trichocryptomania, also known as trichorrexomania. These conditions are commonly described in the context of psychiatric disorders. Nevertheless, there exists reports in otherwise healthy patients that suffer a form of no cicatricial alopecia, such as alopecia areata. We communicate 3 cases of male androgenetic alopecia with patterned miniaturization that coexisted with trichoscopic findings of trichoteiromania. The presence of brush-like ends or broom hairs is a highly suggestive feature of this entity. To the best of our knowledge, this association was not previously reported in the medical literature. The possibility of self-induced hair loss should be kept in mind during every follow-up visit in all types of alopecia, remembering that hair loss itself is already a distressing condition.