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Teach patients with acne keloidalis nuchae that they can prevent further irritation of the affected area by not wearing head gear that rubs on the involved area.
Amongst the less frequent causes, systemic lupus erythematosus (SLE) was seen in 5% cases followed by scleroderma, dermatomyositis, keratosis follicularis spinulosa decalvans (Figure 3), aplasia cutis, kerion, follicular mucinosis, pemphigus, dissecting cellulitis of scalp/ pyogenic folliculitis (Figure 4) and acne keloidalis nuchae in 2.
The following scarring and nonscarring alopecias should be considered in the differential diagnosis: dissecting cellulitis of the scalp, central centrifugal cicatricial alopecia (CCCA), acne keloidalis nuchae, erosive pustular dermatosis, lichen planopilaris (LPP), inflammatory tinea capitis, and secondary syphilis.