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Acne Keloidalis Nuchae and the Metabolic Syndrome: A Population-Based Study

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Abstract

Background

The association between acne keloidalis nuchae (AKN) and the metabolic syndrome (MS) has been reported anecdotally. However, it is yet to be investigated in the setting of controlled studies, leaving this topic inconclusive in the current literature.

Objective

The aim was to estimate the association between AKN and the MS and its components, utilizing one of the largest cohorts of patients with AKN.

Methods

A retrospective, population-based, cross-sectional study was performed between 2005 and 2018. We utilized the database of Clalit Health Services, the largest public healthcare provider organization in Israel. The current study encompassed data collected from general community clinics, primary care, and referral centers, as well as from ambulatory and hospital care.

Results

A total of 2677 patients with AKN and 13,190 controls were included. The prevalence of the MS was greater in patients with AKN than in control subjects (16.1% vs. 6.6%, respectively; odds ratio [OR] 2.72; 95% confidence interval [CI] 2.40–3.08; P < 0.001). Obesity demonstrated the strongest association with AKN (OR 3.00; 95% CI 2.75–3.28), followed by type 2 diabetes mellitus (OR 2.47; 95% CI 2.20–2.77), hypertension (OR 1.82; 95% CI 1.63–2.05), and dyslipidemia (OR 1.60; 95% CI 1.46–1.75). Estimates were not altered significantly after controlling for putative confounding factors.

Conclusions

A strong association was observed between AKN and the MS on the one hand, and with every one of its four components on the other. Physicians treating patients with AKN should be aware of this possible comorbidity. Patients with AKN should be carefully assessed for comorbid metabolic disorders.

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Author information

Authors and Affiliations

  1. Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany

    Khalaf Kridin

  2. Clalit Health Services, Tel Aviv, Israel

    Arieh Solomon

  3. Department of Behavioral Sciences, Ariel University, Ariel, Israel

    Dana Tzur-Bitan

  4. Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

    Giovanni Damiani

  5. Department of Quality Measurements and Research, Chief Physician’s Office, Clalit Health Services, Tel Aviv, Israel

    Doron Comaneshter & Arnon D. Cohen

  6. Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel

    Arnon D. Cohen

Authors
  1. Khalaf Kridin
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  2. Arieh Solomon
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  3. Dana Tzur-Bitan
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  4. Giovanni Damiani
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  5. Doron Comaneshter
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  6. Arnon D. Cohen
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Contributions

KK, DC, and ADC had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: KK and AS. Acquisition, analysis, and interpretation of data: KK and ADC. Drafting of the manuscript: KK, AS, and GD. Critical revision of the manuscript for important intellectual content: KK, ADC, and DT-B. Statistical analysis: DT-B and GD. Obtained funding: None. Administrative, technical, or material support: ADC and DC. Study supervision: KK and ADC.

Corresponding author

Correspondence to Khalaf Kridin.

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Funding

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Conflict of interest

ADC served as an advisor, investigator, or speaker for Abbvie, BI, Dexcel Pharma, Janssen, Novartis, Perrigo, Pfizer, and Rafa. None of the other authors have any conflicts of interest to declare.

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Kridin, K., Solomon, A., Tzur-Bitan, D. et al. Acne Keloidalis Nuchae and the Metabolic Syndrome: A Population-Based Study. Am J Clin Dermatol 21, 733–739 (2020). https://doi.org/10.1007/s40257-020-00541-z

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  • DOI: https://doi.org/10.1007/s40257-020-00541-z

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