A research-focused short video examines a recurring combination of acne keloidalis nuchae, dissecting cellulitis and secondary cutis verticis gyrata, with PIILIF appearing across biopsy sites. The observation is a candidate pattern for further study, not a conclusion that every scalp bump will progress into these conditions.
When three scalp conditions appear together
What if acne keloidalis nuchae is only one part of a broader scalp pattern? In the short video, I describe three patients in whom we documented severe acne keloidalis nuchae (AKN) at the nape, dissecting cellulitis (DCS) across the scalp and secondary cutis verticis gyrata (CVG), which produces deep scalp folds.
The central clinical point is not that these diagnoses are interchangeable. It is that one condition can be missed when attention stops at the most obvious finding. As I explain in the video, when we see one of these conditions, the entire scalp and nape deserve careful evaluation for the others.
PIILIF as a possible common thread
Biopsy findings added another layer. Areas that appeared clinically unaffected showed PIILIF, described in the supplied material as inflammation and early fibrosis around the upper portion of the hair follicles. In the video, I describe PIILIF as a subtle autoimmune inflammatory condition found at every biopsy site and as a possible precursor linking AKN and DCS.
That observation is a research signal, not a settled mechanism. The current finding identifies a candidate pattern that requires further validation, including larger studies.
Why a comprehensive scalp evaluation matters
The caption highlights persistent bumps, drainage, tenderness, hair loss or changing scalp folds as reasons that may warrant a comprehensive evaluation. The practical message for clinicians is to look beyond the area where symptoms are most visible and assess the entire scalp and nape.
The research does not mean that every scalp bump will progress into AKN, DCS or CVG. It points instead to a pattern worth studying further and to the importance of recognizing potentially overlapping findings early.
Watch the Short Video
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Learn more about AKN treatment: DrU.com AKN Treatment
Medical disclaimer: This article is for educational purposes only and is not a substitute for individualized medical diagnosis or treatment. Research findings described here are preliminary and require further validation.
Further Reading
- https://dru.com/acne-keloidalis-nuchae-dissecting-cellulitis-cvg-syndrome/
- Umar S, Ogah O, Yang J, Tan BH, Aiead N, Shitabata PK. A Candidate Syndromic Triad of Acne Keloidalis Nuchae, Dissecting Cellulitis, and Secondary Cutis Verticis Gyrata. Clin Cosmet Investig Dermatol. 2026 Aug 28;19:615576. doi: 10.2147/CCID.S615576. PMID: 42683347; PMCID: PMC13532648.
https://www.dovepress.com/a-candidate-syndromic-triad-of-acne-keloidalis-nuchae-dissecting-cellu-peer-reviewed-fulltext-article-CCID
