Acne Keloidalis Nuchae: Risk Factors and Associated Disorders – A Retrospective Study

The retrospective study conducted at the University Hospital of the West Indies from 2000 to 2014 identified 43 cases of acne keloidalis nuchae (AKN) among 1031 new patients, with a male to female ratio of approximately 7:1 and a mean age of onset at 25.4 years. The study found associations between AKN and pseudofolliculitis barbae, chronic scalp folliculitis, and metabolic syndrome components, particularly hypertension. Patients with hypertension were 6.75 times more likely to have lesions beyond the nape and occipital scalp, while those with any metabolic syndrome feature were 14 times more likely to have extended lesions. A higher prevalence of seborrheic dermatitis and a potential role for Malassezia species in AKN pathogenesis were noted, as well as higher rates of diabetes mellitus and obesity/overweight compared to the general Jamaican population. The study suggested that AKN might have multifactorial causes and highlighted the need for further research, acknowledging limitations such as its retrospective nature and small sample size.