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Revealing a Common Precursor Condition in Acne Keloidalis Nuchae and Primary Cicatricial Alopecias

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Published on September 5, 2023. Last Updated on September 13, 2023.

Dr. Sanusi Umar, known as Dr. Bumpinator among fellow researchers and medical professionals, and his colleagues embarked on an investigative journey to explore the potential link between acne keloidalis nuchae (AKN) and primary cicatricial alopecias (PCAs). Their hypothesis centered on the existence of an underlying condition that precedes the development of AKN and other hair loss disorders. To unveil this connection, they utilized trichoscopy-guided biopsies and conducted comprehensive clinical assessments.

This noteworthy study found its home in the pages of the Clinical, Cosmetic and Investigational Dermatology Journal and holds the potential to transform the understanding and approach to treating various hair and scalp conditions. Dr. Bumpinator is the lead author of the paper titled “Unveiling a Shared Precursor Condition for Acne Keloidalis Nuchae and Primary Cicatricial Alopecias.”

PIILIF may be the shared precursor for AKN and other PCA conditions.
The groundbreaking study was published in the Clinical, Cosmetic and Investigational Dermatology Journal. This patient has a diagnosis of AKN in the nape area and FD in the right vertex area.

Revealing the Concealed Precursor: PIILIF

Their research journey led to unmasking a hidden precursor they termed “perifollicular infundibulo-isthmic lymphocytoplasmic infiltrates and fibrosis,” or PIILIF. The team identified this subclinical disease in all 41 male patients with AKN, not only in the affected AKN zones but also in seemingly healthy scalp regions distant from the AKN lesions. Biopsy images vividly displayed PIILIF, with vertical and horizontal biopsies providing essential insights.

The significance of their findings lies in the potential link they established between PIILIF and various primary cicatricial alopecias. PCAs include challenging conditions such as dreaded AKN bumps and folliculitis decalvans (FD). This discovery bears crucial implications for the early diagnosis and management of these conditions, prompting a shift in focus beyond visible symptoms to explore hidden precursors as potential causative factors.

NAS biopsy showing PIILIF (A-vertical biopsy, B-horizontal biopsy).
NAS biopsy showing PIILIF (A-vertical biopsy, B-horizontal biopsy).

The Implications in Treatment Strategies

Dr. Bumpinator’s research has a practical clinical focus. It aims to address real-world concerns rather than being confined to a scientific puzzle. The research team posits that PIILIF may play a substantial role in developing different hair and scalp disorders. Detecting its presence holds the promise of more efficient treatment methods and preventive measures. Intervening at the PIILIF stage could prove instrumental in slowing down the progression of AKN and other associated PCAs.

The Road Ahead

As the exploration of the intricate relationship between PIILIF and primary cicatricial alopecias continues, numerous questions remain unanswered. Dr. Bumpinator and his team are driven to unravel what triggers the transition from PIILIF to the more visible alopecia conditions, whether genetic factors predispose individuals to PIILIF, and how treatment approaches can be tailored effectively to target this hidden precursor.

In conclusion

Dr. Bumpinator’s research substantially contributes to comprehending hair and scalp disorders. It is another attempt at getting closer to the permanent termination of the back of head bumps. Identifying the common precursor condition of AKN and PCAs paves the way for further research and treatment advancement. They hope this discovery will foster cooperation among researchers, dermatologists, and medical practitioners, sparking a reevaluation of the approach to these conditions. As they delve into the intricacies of scalp issues, they remain open to the possibilities beneath the surface, aiming to brighten the future of dermatology and hair health through their innovative discoveries and insights.