FOLLICULITIS KELOIDALIS NUCHAE

This literally means "keloid-forming folliculitis of the neck". It may start
after the neck is shaved. It is a common condition in African males. A
deep folliculitis, usually caused by staphylococci progresses to a chronic
fibrosing folliculitis and peri-folliculitis. Keloidal scars are produced in
the deeper cutaneous tissue. New papules and pustules occur at the rims
of the keloid. The course is very chronic.
Management of folliculitis keloidalis nuchae
Treatment is difficult.
- In active, pustular stages use doxycycline 100 mg twice daily for 2 weeks up to one
month followed by doxycycline 100 mg once daily for 2 weeks up to one month or
longer or other long-term antibiotics according to sensitivity tests.
- Excision of scars, with or without skin grafting. Recurrence of keloid is possible but
seems to occur less often when skin grafts are not performed and the wound is
allowed to heal per secundam, leaving an atrophic scar. Keloids may respond to
injections of steroid suspension such as triamcinolone acetonide, 10 mg diluted 1:3
to 1:5 with a local anaesthetic, every 2 to 4 weeks for several months.
- A strong steroid e.g. betamethasone ointment twice daily on lesions.
- Cryosurgery or lasersurgery may be helpful.