■小型观察性研究表明,在几种原发性瘢痕性脱发的正常头皮区发生亚临床疾病。为了帮助病人管理,我们开始常规评估痤疮keloidalisnuchae(AKN)患者的整个头皮,包括镜引导活检。
这项回顾性研究评估了2022年6月至12月在一家诊所连续出现AKN的41例患者。临床评估了距AKN受影响区域至少5cm处的上顶叶头皮中的原发性病变和外观正常的头皮。和显示毛囊周围红斑或鳞片/模型的区域进行活检和组织学分析。
■四十一人与AKN,包括20名非洲裔男子,17西班牙裔,和4个欧洲血统的白人,进行了评估。所有患者,包括22%与相关的毛囊炎decalvans,在正常的头皮区域显示出头皮范围的毛囊周围红斑或鳞屑。所有患者均显示滤泡周围漏斗状-峡部淋巴细胞浸润和纤维化(PIILIF)的组织学证据,96%的人显示出Vellus或小型化的头发缺失。PIILIF在临床上常被误认为是脂溢性皮炎(44-51%)。所有白人患者均有轻度丘疹性痤疮,被误认为脂溢性皮炎。
■PIILIF可能是广泛的原发性瘢痕性脱发的前兆,包括AKN和毛囊炎。这一发现对AKN和其他原发性瘢痕性脱发的早期诊断和治疗具有重要意义。
痤疮keloidalisnuchae(AKN)是一种脱发和头皮状况,以疤痕和炎症为特征。这种情况属于一组慢性头发和头皮问题,称为原发性瘢痕性脱发(PCA)。目前AKN和类似PCAs的治疗通常效果不佳,而条件往往会回归。我们发现了一种隐藏的头皮状况,可能会导致AKN和其他PCA。这是一种微妙的疾病,会影响整个头皮,即使它可能没有明显的症状。在我们的研究中,我们在所有41名AKN患者中观察到了这种情况,它的特点是头发和头皮的结构和免疫系统反应的某些变化。其他研究将这种情况与各种其他PCA联系起来。我们认为这种隐藏的情况可能会导致AKN并使其在治疗后复发。这项研究表明,治疗AKN可能需要更广泛的方法,而不仅仅是治疗可见的症状。由于此隐藏条件存在于其他PCA中,这可能是一个共同的原因。
UNASSIGNED: Small observational studies suggest subclinical disease occurrence in the normal-appearing scalp zones of several primary cicatricial alopecias. To aid patient management, we began routinely evaluating the entire scalp of patients with acne keloidalis nuchae (AKN), including trichoscopy-guided biopsies.
UNASSIGNED: This retrospective study evaluated 41 patients sequentially presenting with AKN at a single clinic between June and December 2022. Primary lesions and normal-appearing scalp in the superior parietal scalp at least 5 cm away from AKN-affected zones were clinically evaluated, and areas showing perifollicular erythema or scales/casts on trichoscopy were biopsied and histologically analyzed.
UNASSIGNED: Forty-one men with AKN, including 20 men of African descent, 17 Hispanic, and 4 European-descended Whites, were evaluated. All patients, including 22% with associated folliculitis decalvans, showed scalp-wide trichoscopy signs of perifollicular erythema or scaling in normal-appearing scalp areas. All patients showed histologic evidence of perifollicular infundibulo-isthmic lymphocytoplasmic infiltrates and fibrosis (PIILIF), with 96% showing Vellus or miniaturized hair absence. PIILIF was often clinically mistaken for seborrheic dermatitis (44-51%). All White patients had mild papular acne keloidalis nuchae lesions mistaken for seborrheic dermatitis.
UNASSIGNED: PIILIF may be a precursor to a wide spectrum of primary cicatricial alopecias, including AKN and folliculitis decalvans. This finding carries implications for the early diagnosis and management of AKN and other primary cicatricial alopecias.
Acne keloidalis nuchae (AKN) is a type of hair loss and scalp condition marked by scarring and inflammation. This condition falls under a group of chronic hair and scalp issues known as primary cicatricial alopecia (PCA). Current treatments for AKN and similar PCAs often do not work well, and the condition tends to return. We have found a hidden scalp condition that could be causing AKN and other PCAs. It’s a subtle disease that affects the entire scalp, even though it might not show noticeable symptoms. We have observed this condition in all 41 AKN patients in our study, and it’s characterized by certain changes in the hair and scalp’s structure and immune system response. Other studies have linked this condition to various other PCAs. We believe this hidden condition could be causing AKN and making it come back after treatment. This study suggests that treating AKN might require a broader approach beyond just treating the visible symptoms. Since this hidden condition exists in other PCAs, it might be a common cause.