It is a chronic condition which involves scalp and the back of the neck. Folliculitis Keloidalis Nuchae generally occurs in African American men. People in the age of fifteen to thirty years of age are more likely to be affected by Folliculitis Keloidalis Nuchae. It is very difficult to treat Folliculitis Keloidalis Nuchae. Men are more likely to be affected by Folliculitis Keloidalis Nuchae, the ratio of men to women being 20:1.

Causes

The disease is common in people with very curly hair. The hair grows in the neck or scalp and thereby causing inflammation. Folliculitis Keloidalis Nuchae is common in people who have a tendency towards acne. This problem can be aggravated by the use of hair pomade containing lanolin. Make sure the pomade you are using does not contain lanolin. Some of the causes of Folliculitis Keloidalis Nuchae can be summarized as follows:

·    Usage of antiepileptic drugs.

·    An increase in the number of mast cells in the occipital region.

·    Chronic low grade bacterial infection.

Symptoms

The papules develop on the nape of the neck or on the occipital part of the scalp. Pustules which are generally short-lived may be present in the same areas. As the disease progresses the papules may appear and enlarge. Plaques are generally a few centimeters in diameter and reach more than 10 cm in diameter.

Folliculitis generally starts at the upper 1/3^rd of the hair follicle. In all stages of the disease Sebaceous glands are either markedly diminished or are completely absent. In case of more advance lesions the hair follicles are disrupted. The broken hair fragments are enclosed by granulomatous inflammation. One single follicle shows several stages of inflammation.

The lower part of the follicle is not affected until the later phase in the disease.     The hair has no shaft to take them to the surface and thus probably proliferate beneath fibrotic tissue

Treatment

There is no cure for Folliculitis Keloidalis Nuchae. Medication is used to improve the condition over time. Some measures that can be helpful are:

Make sure that the clothing does not rub the back of the neck. A 3 month course of rifampicin and clindamycin antibiotics can be helpful. Antibiotic pills and antibiotic lotion are made use of to cure the condition. Cortisone injections may help reduce keloidal scarring. Surgical drainage may be required in some areas i.e. surgically removing the affected area. Vaporization and laser excision can also be made use of. In some cases radiotherapy is advised.

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