# A Classic Presentation of Acne Keloidalis Nuchae in a Black Male

## TL;DR

This case report describes a Black male patient with a classic presentation of acne keloidalis nuchae, a skin condition causing scarring and hair loss.

## Contribution

The novelty lies in presenting a typical clinical case of AKN in an African American male, emphasizing early diagnosis and treatment.

## Key findings

- AKN presented with firm papules, pustules, and scarring on the nuchal scalp.
- Early intervention with antimicrobials and corticosteroids is recommended to prevent permanent scarring.
- The patient's case highlights the importance of recognizing AKN in people of color.

## Abstract

Acne keloidalis nuchae (AKN), also known as folliculitis keloidalis nuchae and nuchal keloid acne, is a chronic inflammatory skin disorder of the hair follicle. Predominantly occurring in the nuchal and occipital scalp, it can lead to keloid-like plaques and cicatricial alopecia. Primarily affecting people of color, more specifically African American individuals, it is associated with haircuts, friction, or trauma among a variety of other less common causes. The diagnosis is clinical with physical exam findings showing firm, dome-shaped papules or pustules, hypertrophic scars, inflammation, and alopecia. Although challenging as the disease progresses, management includes topical and systemic antimicrobials, corticosteroids, cryotherapy, laser therapy, and surgical excision. Early intervention is vital as it helps minimize the risk of permanent scarring and psychosocial impact. The following case report is about a young, African American male who presented to the outpatient clinic with findings concerning for AKN.