How do you approach treating patients with acne keloidalis nuchae who do not respond to a potent topical steroid or retinoid?   

For mild disease, topical steroids and topical clindamycin solution alone or in combination with benzoyl peroxide wash or gel are recommended. It is also important to counsel patients to reduce friction to the area (usually the occipital scalp) and avoid cutting hair close to the skin. For moderate ...

Very thorough and excellent answer! Intralesional triamcinolone is quite effective at reducing the papules, and can be performed in separate sessions if there are a lot of lesions. Topical numbing can be applied 1 hour prior to an appointment to help a little with the needle pricks. If there are l...