Improving acne keloidalis nuchae with targeted ultraviolet B treatment: a prospective, randomized, split‐scalp comparison study. (1st October 2014)

• Record Type: Journal Article
• Authors: 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.
• Is Part Of: British journal of dermatology. Volume 171:Number 5(2014:Nov.)
• Page Start: 1156
• Page End: 1163
• Publication Date: 2014-10-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.13119
• Languages: English
• ISSNs: 0007-0963

Abstract

<abstract abstract-type="main" id="bjd13119-abs-0001"> <title>Summary</title> <sec id="bjd13119-sec-0001" sec-type="section"> <title>Background</title> <p>Acne keloidalis nuchae (AKN) is a chronic scarring folliculitis with fibrotic papules on the occipital scalp. Its treatment is limited and unsatisfactory.</p> </sec> <sec id="bjd13119-sec-0002" sec-type="section"> <title>Objectives</title> <p>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.</p> </sec> <sec id="bjd13119-sec-0003" sec-type="section"> <title>Methods</title> <p>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 <italic>MMP1</italic>, <italic> MMP9</italic>, <italic> TGFB1</italic> and <italic>COL1A1 </italic>mRNA expression by quantitative reverse‐transcription polymerase chain reaction.</p> </sec> <sec id="bjd13119-sec-0004" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = 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 (<italic>P</italic> = 0·04) after 16 weeks of tUVB.</p> </sec> <sec id="bjd13119-sec-0005" sec-type="section"> <title>Conclusions</title> <p>tUVB significantly improved the clinical appearance of AKN, led to patient satisfaction and was well tolerated.</p> </sec> </abstract>