Acne keloidalis nuchae: A role for low-dose radiotherapy

Acne keloidalis nuchae (AKN) is a folliculocentric scalp disease mainly affecting men of color. Numerous studies have shown that it is not a true keloid1-3; when all follicular structures within the lesion are eliminated by surgery or laser, the lesion is permanently eliminated.3-6 Millan-Cayetano et al7 reported the use of radiation therapy (RT) in a patient with an isolated AKN lesion with no recurrence. Permanent killing of lesional hair by radiation coincided with lesion regression and permanent elimination of the disease, further supporting the folliculocentric foundation of AKN, which is resolved by focusing the treatment objective on removing hair located within the lesion.