Acne keloidalis nuchae L73.0

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

Dieser Artikel auf Deutsch


acne keloidalis; Acne sclerotisans nuchae; Folliculite pilo-sebacée chronic; Folliculitis nuchae sclerotisans; Folliculitis scleroticans nuchae; keloidal folliculitis; Neck Keloid; papillary dermatitis capillitii (Kaposi); sycosis framboesiformis (Hebra); Sycosis nuchae sclerotisans

This section has been translated automatically.

Hebra and Kaposi, 1860

This section has been translated automatically.

Eminently chronic fibrosing and indurating folliculitis and perifolliculitis of the neck region, leading to irreversible hair loss and progressive, extensive, bulging keloid scarring.

This section has been translated automatically.

Etio: discussed is an initial staphylococcal folliculitis after short haircut or shaving. There is no pathogenetic relationship to acne (localization, absence of comedones). From unknown cause transition to a chronic fibrosing process with tissue hyperplasia and pressure atrophy of the follicles.

This section has been translated automatically.

Occurs only in men, after the age of puberty; preferred in people with dark skin.

This section has been translated automatically.

Neck, neck hairline, possible extension to the back of the head.

Clinical features
This section has been translated automatically.

Initially individual, small, red, follicular papules and pustules, from which develop hard, dark red, hemispherical, shiny, differently sized, solid papules and nodules pierced by a terminal or vellus hair, which can confluent to form larger plate-like structures.

Later increasing sclerotic, almost board-like hardening of the skin between them.

Beam-like, transverse, coarse, bulging keloids with tufts of hair.

Deep epithelium-lined fistula ducts.

Peripheral continuous sometimes intermittent progression of the sclerosing inflammation over a period of years.

Differential diagnosis
This section has been translated automatically.

  • Boils: Highly painful, acute; starting from 1 follicle; no multiple pustules on the surface; clearly fluctuating.
  • Folliculitis decalvans: Eminently chronic course of the disease mostly over years; scarred alopecia; highly red skin changes in the centre mostly atrophic shiny and peripheral follicular papules; later pustular transformation and crust formation. Irregularly shaped scar foci with small spots of irreversible hair loss result. Formation of tuft hairs.
  • Tinea capitis profunda: Mostly occurring in children! Subacute or acute course; itchy or moderately painful, 0.5-5.0 cm large, usually well defined, cushion-like raised, purulent, highly red plaques or nodules. Pus can be emptied under pressure. Hair is missing in the lesion; existing hair can be easily and usually painlessly extracted; preparation of a native preparation for fungal detection.

This section has been translated automatically.

This section has been translated automatically.

Chronic recurrent course.

This section has been translated automatically.

  1. Adamson HG (1914) Dermatitis papillaris capillittii (Kaposi). Acne keloid. Br J Dermatol 26: 69-83
  2. Alexis A et al (2014) Folliculitis keloidalis nuchae and pseudofolliculitis barbae: are prevention and effective treatment within reach? Dermatol Clin 32:183-191
  3. Gloster HM Jr (2000) The surgical management of extensive cases of acne keloidalis nuchae. Arch Dermatol 136: 1376-1379
  4. Hebra v. F, Kaposi M (1860) Textbook on skin diseases. Enke, Erlangen, vol. 1, p. 506
  5. Kaposi M (1894) On some unusual forms of acne (folliculitis). Arch Dermatol Syph 26: 87-96
  6. Kelly AP (2003) Pseudofolliculitis barbae and acne keloidalis nuchae. Dermatol Clin 21: 645-653
  7. Sparrow LC (2000) Acne keloidalis is a form of primary scarring alopecia. Arch Dermatol 136: 479-484
  8. Shapero J et al (2011) Acne keloidalis nuchae is scar and keloid formation condary
    to mechanically induced folliculitis. J Cutan Med Surg 15:238-240


Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 29.10.2020