Indurated plaque on the nape of the neck
How to cite this article: Couppoussamy KI, Purushothaman S. Indurated plaque on the nape of the neck. CosmoDerma 2023;3:6.
A 40-year-old male presented with asymptomatic raised lesion over the nape of the neck for 1 year. On examination, skin colored indurated plaque of size 3 × 4 cm is present over the nape of the neck with multiple tiny papules along the margin of the plaque with scarring alopecia [Figure 1]. Based on the history and clinical examination, a diagnosis of acne keloidalis nuchae was made. The lesion responded to intralesional triamcinolone injection 10 mg/mL over three sessions given monthly. Acne keloidalis nuchae is a type of chronic folliculitis characterized by papules and pustules in the nuchal and occipital region. Clinically, it can resemble keloid in the later stages, by histologically, it shows perifollicular inflammation with lymphocytes and plasma cells at the level of isthmus and lower infundibulum. It lacks the histological features of keloid.
The treatment options include topical steroids, intralesional steroid, oral tetracyclines, and surgical excision.
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