Folliculitis Keloidalis is also a name for Acne Keloidalis Nuchae. If treatment is not sought right away during the initial stages, it progresses into a large unsightly tissue mass.
Folliculitis Keloidalis is another name for Acne Keloidalis Nuchae. When it first manifests, it looks like bumps on the back of the neck. This happens when the hair follicles become inflamed. In other words, the body’s immune system will start attacking the follicles. This will result in a buildup of discharge and tissue. If treatment is not sought early, a large tumor will develop.
Here is an example of what this often looks like:
Patient with Advanced Folliculitis Keloidalis Nuchae before AKN surgery
The causes are not exactly clear. And it is quite possible that different factors trigger the condition in different people. Here are some common examples:
(1) irritation caused by clothing (e.g. shirt collars)
(2) close shaving as a result of hair cuts
(3) ingrown hairs that grow back into the skin, causing an immune system reaction
This condition is often seen in patients of African descent. Many experts believe that the curly hair will re enter the skin and trigger an inflammatory reaction.
However Folliculitis Keloidalis Nuchae can also occur in individuals who have straight hair, like the patient in the picture. In all likelihood, there is probably a genetic predisposition that causes this condition. Some speculate that there is a high concentration of mast cells (part of the immune system) on the back of the neck. And this may be due to genetics.
Medication for Folliculitis Keloidalis Nuchae
Medications can be a helpful treatment for symptoms of Folliculitis Keloidalis Nuchae, (or Acne Keloidalis Nuchae). This can minimize itching, swelling, discharge and pain. However, the use of drugs does not get rid of the appearance of the tissue mass. They can become flatter or smaller in size. However, the effectiveness of medications can be reduced as the condition advances.
Surgery for Folliculitis Keloidalis Nuchae
Folliculitis Keloidalis Nuchae can be removed through surgery. The tissue mass is often excised as an elliptical shape. Wound closure is an important part of this process. Although new tissue can fill the gap, if the wound is not closed, the AKN tissue mass can return.
Closing the wound completely cannot be done right away. Otherwise, this may prevent the normal range of head movement. Therefore this process needs to happen gradually.
In this patient, serial tension stitching was used to give these results which are seen eight weeks after his surgery:
