Robert’s case brought acne keloidalis nuchae together with folliculitis decalvans at a level that left Dr. Sanusi Umar without an established protocol to follow. In this Baldcast chapter, Dr. Umar explains how medical limitations, the possibility of highly invasive surgery, and uncertainty around treatment forced him to think beyond the usual options while Robert continued to place his trust in the process.
When the Standard Path Was Not Available
Dr. Umar begins by telling Robert that no one had truly tackled his condition. The challenge was not simply choosing among familiar treatments. “We had to think outside the box,” he says, describing a process built around scientific evidence and his reasoning about what was driving the disease.
At one stage, the case became serious enough that Dr. Umar considered whether part of the skull might have to be removed and consulted another doctor about that possibility. Robert remembers reaching a point where he was prepared for that possibility. Ultimately, however, they did not proceed with that route.
Medical Limits Changed the Treatment Strategy
Dr. Umar explains that insurance was one issue, and Robert also had diabetes and other medical conditions that precluded moving forward with that kind of invasive surgery. Those limitations forced Dr. Umar to begin thinking about an alternative treatment rather than continuing toward the surgical plan.
The matching caption places the clinical problem in the context of Robert’s combined acne keloidalis nuchae and folliculitis decalvans. It also notes that surgery was highly invasive and that radiation carried long-term risks. With no established protocol available, Dr. Umar says, “We had to come up with our own protocols, what to do with the case.”
Faith Became Part of the Story
The chapter is not only about a difficult clinical decision. Dr. Umar also reflects on Robert’s response to uncertainty. Robert could have lost faith or disappeared from care, he says, but he did not. Dr. Umar points to that resilience as one of the most important parts of the experience.
That is where this short chapter leaves the story. It does not reveal a later outcome. Instead, it focuses on the moment when a complex case required a new approach and on Robert’s willingness to keep going even when the path was unclear. For viewers searching terms such as hair loss after infection, the chapter also reinforces why an individual diagnosis and treatment plan matter when more than one scalp condition is involved.
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Medical Disclaimer
This article presents one patient’s experience for educational purposes only. Individual conditions, treatment plans, risks, and outcomes vary. It does not provide a diagnosis or replace evaluation and treatment by a qualified healthcare professional.
Further Reading
- https://dru.com/folliculitis-keloidalis-nuchae-life-before-after/
- Umar, S., & Sila, C. R. (2021). Acne keloidalis nuchae: A role for low-dose radiotherapy. JAAD Case Reports, 13, 90–93. https://doi.org/10.1016/j.jdcr.2021.05.008
