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Improving acne keloidalis nuchae with targeted ultraviolet B treatment: a prospective, randomized, split‐scalp comparison study
Author(s) -
Okoye G.A.,
Rainer B.M.,
Leung S.G.,
Suh H.S.,
Kim J.H.,
Nelson A.M.,
Garza L.A.,
Chien A.L.,
Kang S.
Publication year - 2014
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.13119
Subject(s) - medicine , scalp , lesion , dermatology , folliculitis , prospective cohort study , randomization , surgery , randomized controlled trial
Summary Background Acne keloidalis nuchae ( AKN ) is a chronic scarring folliculitis with fibrotic papules on the occipital scalp. Its treatment is limited and unsatisfactory. Objectives To determine whether targeted ultraviolet B ( tUVB ) phototherapy will (i) improve the clinical appearance of AKN and (ii) induce extracellular matrix remodelling in affected lesions. Methods Eleven patients with AKN were enrolled in a prospective, randomized, split‐scalp comparison study. One randomly selected side of the scalp was treated with tUVB up to three times weekly for 8 weeks. After week 8, both sides were treated for eight additional weeks. Assessment included lesion counts in two 3 × 3‐cm regions of interest (ROIs), one on each side of the scalp (ROI‐1: tUVB weeks 0–16, ROI‐2: tUVB weeks 9–16), patient self‐assessment and analysis of MMP1 , MMP9 , TGFB1 and COL1A1 mRNA expression by quantitative reverse‐transcription polymerase chain reaction. Results Before treatment, the mean lesion count was similar between tUVB ‐treated and untreated sides (14·8 vs. 15·0). After 8 weeks of tUVB , the mean lesion count decreased significantly to 9·4 ± 1·2 ( P = 0·03), with no change on the untreated side. With continued treatment, the mean lesion count in ROI‐1 decreased further to 7 ± 1·5 ( P = 0·04) after 16 weeks of tUVB . Conclusions tUVB significantly improved the clinical appearance of AKN, led to patient satisfaction and was well tolerated.