Glenn M J, Bennett R G, Kelly A P
King-Drew Medical Center, Los Angeles, CA 90059, USA.
J Am Acad Dermatol. 1995 Aug;33(2 Pt 1):243-6. doi: 10.1016/0190-9622(95)90242-2.
Acne keloidalis nuchae (AKN) is a chronic inflammatory disorder of the posterior aspect of the neck and occipital region of the scalp. Despite numerous medical and surgical treatment modalities, few offer cure or a superior cosmetic result for patients with extensive disease.
Our purpose was to determine whether excision with second-intention healing is an effective therapeutic modality for AKN.
Excision of the involved area to the level of the muscle fascia or deep subcutaneous tissue was performed in six patients. Postoperative sites healed by second intention.
Four of six patients had a horizontal elliptic excision of the involved area that included the posterior hairline, with good to excellent results. The other two, who received nonelliptic excision of affected scalp that spared the hairline, had slower wound healing and poor contraction.
Best results were achieved in excision of AKN with second-intention healing when the excision was a horizontal ellipse of the posterior aspect of the scalp including the posterior hairline.
瘢痕疙瘩性痤疮（AKN）是一种发生于颈部后方和头皮枕部区域的慢性炎症性疾病。尽管有多种医学和外科治疗方式，但对于患有广泛性疾病的患者而言，很少能实现治愈或获得理想的美容效果。
我们的目的是确定二期愈合切除法是否是治疗AKN的有效治疗方式。
对6例患者进行手术，将受累区域切除至肌肉筋膜或深皮下组织水平。术后创口通过二期愈合。
6例患者中有4例对包括后发际线在内的受累区域进行了水平椭圆形切除，效果良好至极佳。另外2例患者对未累及发际线的受累头皮进行了非椭圆形切除，伤口愈合较慢且收缩不良。
当切除范围为包括后发际线在内的头皮后部水平椭圆形时，二期愈合切除AKN可取得最佳效果。
