What causes acne keloidalis nuchae (AKN)?

Updated: Nov 13, 2020
  • Author: Elizabeth K Satter, MD, MPH; Chief Editor: William D James, MD  more...
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Suggested etiologies include the following [1, 3, 4, 9, 12, 13, 14, 15, 16, 17] :

  • Close shaving of the neck: This often exacerbates the condition. The sharp, curved hairs reenter the skin and invoke an acute inflammatory response.

  • Constant irritation from shirt collars or athletic gear: This irritation causes shearing of the hairs.

  • Chronic low-grade bacterial infections

  • Use of antiepileptic drugs or cyclosporine

  • An increased number of mast cells in the occipital region [18]

Reports have linked acne keloidalis nuchae (AKN) with keratosis follicularis spinulosa decalvans, a rare X-linked disorder in which individuals have a genetic predisposition toward follicular hyperkeratosis and subsequent inflammation. [19, 20]

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