00:00Acne keloidalis nookie, AKN, is a condition characterized by follicular-based papules
00:05and pustules that ultimately results in firm papules and keloid-like fibrotic plaques.
00:11Acne keloidalis nookie most frequently involves the posterior neck and occipital scalp and
00:17develops almost exclusively in young, African-American men.
00:21One although Acne keloidalis nookie is the name most often used in the literature for
00:25this condition, the term is a misnomer because this condition does not occur in association
00:30with or as a complication of acne vulgaris, but rather occurs due to chronic and recurrent
00:36folliculitis and or pseudofolliculitis, ingrown hairs.
00:40Moreover, the lesions are not true keloids on histology.
00:44Lastly, because this condition can also occur on the vertex scalp, therefore, some authors
00:50suggest using the term folliculitis keloidalis to more accurately describe this condition.
00:56Lesions initially manifest as mildly pruritic follicular-based papules and pustules most
01:02commonly on the nape of the neck and ultimately the chronic inflammation results in development
01:07of keloid-like papules which often coalesce into plaques.
01:11Frequently within and at the edge of these plaques broken hair shafts, tufted hairs,
01:16and ingrown hairs can be identified.
01:18These plaques expand over time, are frequently painful and disfiguring.
01:23In advanced cases, abscesses and sinus tracts associated with purulent discharge may develop.
01:30Unlike acne vulgaris, comedones are not a common feature.
01:343.
01:35Close shaving of the neck often exacerbates this condition due to development of ingrown
01:39hairs.
01:40Sharp, curved hairs re-enter the skin and invoke an acute inflammatory response.
01:46Constant irritation from shirt collars or athletic gear which results in irregular shearing
01:51of the hairs which subsequently become ingrown.
01:54Chronic low-grade bacterial infections and or increased sensitivity to demodex.
02:00Use of antiepileptic drugs or cyclosporine.
02:04Androgen excess or increased sensitivity to androgens.
02:07An increased number of mast cells in the occipital region.
02:1118.
02:12Several reports have suggested that acne keloidalis noci, AKN, may be caused by a similar process
02:18to keratosis follicularis spinulosa decalvans, which is a rare X-linked disorder that occurs
02:23in individuals with a genetic predisposition toward follicular hyperkeratosis and subsequent
02:29inflammation.
02:30Did you know that the largest AKN bump ever recorded was a whopping 12 centimeters?
02:36Yup, you heard that right.
02:38Imagine having something that big on your skin.
02:40Today, we're diving into the ultimate removal of this massive bump and trust me, you won't
02:46want to miss this.
02:48Welcome back, everyone.
02:49Today, we're talking about something that might sound a bit scary but is super important
02:53in dermatological health, AKN or Acral Keratosis Nodularis.
02:58This skin condition can lead to some seriously uncomfortable bumps and we're going to explore
03:03the significance of removing one of the biggest ones ever encountered.
03:08Presentation of problem slash challenge, so let's get into it.
03:12Having a large AKN bump can be more than just a cosmetic issue.
03:17It can also be a source of discomfort and embarrassment.
03:20Imagine trying to wear your favorite shirt but feeling self-conscious about that noticeable
03:24bump on your arm.
03:26Not to mention, these bumps can sometimes itch or even become painful.
03:31The reason we're here today is to understand why getting rid of these bumps is so crucial.
03:36It's not just about looking good.
03:38It's about feeling good and reclaiming your confidence.
03:41The discomfort and anxiety that come with it can really affect someone's daily life.
03:46So, let's take this challenge head-on.
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