Reconstruction of acne keloidalis nuchae using osmotic tissue expanders—a case series

Abstract

Background

Acne keloidalis nuchae (AKN) is a benign condition of keloid-like papules on the occipital scalp area. Treatment for AKN is divided into conservative and surgical. The use of tissue expander enables preservation of the hirsute area and thereby achieves a good cosmetic result. Osmotic tissue expander is a self-filling device, which absorbs tissue fluids in order to increase skin volume gradually. So far, the use of osmotic expander for reconstruction of AKN has not been described. We present our experience with five consecutive cases of tissue reconstruction using osmotic expanders in AKN.

Methods

Five patients suffering from AKN, median age of 43 years (range 35–50), who were admitted to our department between April 2010 and December 2011 underwent reconstruction using an osmotic tissue expander. All patients had the lesions for a median of 12 years (range 7–15).

Results

In three of the five patients, one expander was used per patient. In the remaining two, two expanders were used. In all the cases, the operative and postoperative management were uneventful with no major complications. A minor complication included partial extrusion of the expander (one patient), which caused an earlier conclusion of the reconstruction, nevertheless with a pleasing result. The average expansion period was 7 weeks (range 4–9). During that time, there was a median of one follow-up visit (range 1–2). Final aesthetic results were satisfactory in all the cases.

Conclusions

Osmotic expander is a reliable tool for tissue expansion. The main advantages of this device make it especially suitable for AKN reconstruction. Its main disadvantages include the inability to control the filling rate and the need to remove it in case of tissue damage.

Level of Evidence: Level V, therapeutic study.