Folliculitis keloidis nuchae.

Abstract

Keloid scars are an idiopathic result of cuts, bruises, lacerations and often from surgical incisions. Medical therapy has been used with some results, but often surgical excision is necessary when the keloids are located in areas of exposed skin. Often skin grafting is necessary. The problem of keloid formation is more common in African Americans and Asians in the United States. Because surgery of these lesions is sometimes considered cosmetic by HMOs and other insurance carriers, there exists a dispute between the medical profession and insurance carriers regarding the medical necessity of surgery. We have operated on many keloids in our practice; however, the case report we are presenting is a unusual and rare case of giant keloid formation requiring extensive surgery and x-ray therapy.