crutchfieldsquare AKN stands for acne keloidalis nuchae. This condition is also known as folliculitis keloidalis nuchae, where small, very itchy bumps can occur at the nape of the neck and back of the scalp. This is most commonly seen in patients of color, particularly those of African descent, and is more prevalent in the male population.

Many male patients believe this condition results from a barber shop treatment where the barber had unclean clippers. This is quite untrue, and I have seen many cases that develop without any previous

 Acne keloidalis  nuchae, or AKN

Acne keloidalis
nuchae, or AKN

haircuts.

One theory is that this condition is a result of a deep fungal infection. I have performed many biopsies and analyzed cultures for fungus and special histology stains, but I have not yet identified a fungus or primary bacterial cause or infection. I believe this condition is an anatomic and genetic variant, with itchy bumps developing from very mild irritation in this particular anatomic location.

Without treatment, the lesion can become quite large and unsightly. While there is no cure for acne keloidalis nuchae, professional treatment can dramatically improve the condition.

Depending on the size of the lesion, there are various treatment options. Smaller bumps can be controlled very effectively when treated with a combination of topical and oral anti-inflammatory medications. In many cases, a short treatment course can provide long-term results.

For moderate-sized lesions, sometimes the addition of injected anti-inflammatory medicines can be very helpful. If the lesions are large or unresponsive to other treatments, a surgical approach with lasers or excision may be required. Regardless of size, the condition can be managed quite well.

For patients who have and want to improve this condition, the best advice is to see a board- certified dermatologist who is experienced and is comfortable treating acne keloidalis nuchae.

 

Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.

 

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