ICD-10: L73.0

Acne keloid, classified under the ICD-10-CM code L73.0, is a specific type of keloid that arises from acne lesions. This condition is characterized by the formation of raised, thickened scars that develop at the site of previous acne lesions, particularly in individuals who are predisposed to keloid formation. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Acne Keloid

Definition

Acne keloid is a form of keloid that occurs following the healing of acne lesions. Keloids are abnormal growths of scar tissue that develop at the site of skin injury, and in the case of acne keloid, they are specifically linked to acne vulgaris. The condition is more prevalent in individuals with darker skin types, where the tendency to form keloids is heightened.

Pathophysiology

The pathophysiology of acne keloid involves an overproduction of collagen during the healing process of acne lesions. When the skin is injured, the body initiates a healing response that includes the formation of collagen to repair the damaged tissue. In some individuals, this process becomes dysregulated, leading to excessive collagen deposition and the formation of a keloid. Factors such as genetic predisposition, skin tension, and the inflammatory response play significant roles in the development of keloids[1][2].

Clinical Features

• Appearance: Acne keloids typically present as firm, raised scars that can vary in color from pink to dark brown, depending on the individual's skin tone. They may be itchy or painful and can grow larger over time.
• Location: These keloids commonly occur on the face, neck, and upper back, where acne lesions are frequently found.
• Symptoms: While some patients may experience discomfort or pruritus (itching), others may have no symptoms at all. The psychological impact of visible keloids can also affect the patient's quality of life[3].

Diagnosis

Diagnosis of acne keloid is primarily clinical, based on the patient's history of acne and the characteristic appearance of the keloid. A thorough examination by a dermatologist is essential to differentiate acne keloids from other types of scars or skin lesions. In some cases, a biopsy may be performed to rule out other conditions, such as dermatofibromas or hypertrophic scars[4].

Treatment Options

The management of acne keloids can be challenging and may include several approaches:

• Intralesional corticosteroid injections: These are commonly used to reduce inflammation and flatten the keloid.
• Surgical excision: In some cases, surgical removal of the keloid may be considered, although this carries a risk of recurrence.
• Cryotherapy: Freezing the keloid can help reduce its size.
• Laser therapy: Various laser treatments can improve the appearance of keloids and reduce symptoms.
• Silicone gel sheets: These can be applied to the keloid to help flatten and soften the scar over time[5][6].

Conclusion

Acne keloid, designated by the ICD-10 code L73.0, is a significant dermatological condition that can arise from acne lesions, particularly in individuals predisposed to keloid formation. Understanding its clinical features, diagnosis, and treatment options is crucial for effective management. Patients experiencing this condition should consult a dermatologist for tailored treatment strategies that address both the physical and psychological impacts of keloids.

References

1. Keloids | Diseases & Conditions.
2. CG-SURG-31 Treatment of Keloids and Scar Revision.
3. ICD-10-CM Diagnosis Code L73.0 - Acne keloid.
4. ICD-10 Version:2019.
5. ICD-10 Version:2015.
6. ICD-10-AM Disease Code List.

Acne keloid, classified under ICD-10-CM code L73.0, is a specific type of keloid that arises from inflammatory acne lesions, particularly in individuals with a predisposition to keloid formation. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for effective diagnosis and management.

Clinical Presentation

Definition and Overview

Acne keloid, also known as acne keloidalis nuchae, is characterized by the development of keloid scars following acne lesions, primarily on the nape of the neck and scalp. This condition is more prevalent in individuals with darker skin types, where the propensity for keloid formation is heightened due to genetic factors[1][2].

Signs and Symptoms

The clinical features of acne keloid can be summarized as follows:

• Keloid Formation: The primary sign is the presence of raised, thickened scars that extend beyond the original site of the acne lesion. These keloids can vary in size and may appear red, purple, or darker than the surrounding skin[3][4].
• Itching and Discomfort: Patients often report pruritus (itching) or tenderness in the affected areas, which can be bothersome and lead to scratching, further exacerbating the condition[5].
• Inflammation: The keloids may be associated with inflammation, presenting as erythema (redness) and swelling around the lesions, particularly during flare-ups[6].
• Location: While commonly found on the nape of the neck, acne keloids can also occur on the scalp and other areas where acne lesions have been present[7].

Patient Characteristics

Demographics

• Age: Acne keloid typically affects adolescents and young adults, particularly those in their late teens to early twenties[8].
• Ethnicity: There is a notable prevalence among individuals with darker skin types, such as African Americans and Hispanics, due to genetic predispositions to keloid formation[9][10].

Risk Factors

• Genetic Predisposition: A family history of keloids significantly increases the likelihood of developing acne keloid, indicating a hereditary component to the condition[11].
• Previous Acne: Individuals with a history of inflammatory acne are at a higher risk of developing keloids, especially if the acne lesions were severe or poorly managed[12].
• Skin Trauma: Any form of skin trauma, including surgical procedures, cuts, or even aggressive acne treatments, can trigger keloid formation in susceptible individuals[13].

Conclusion

Acne keloid (ICD-10 code L73.0) presents with distinct clinical features, including raised, itchy scars that often develop following acne lesions. It predominantly affects younger individuals with darker skin types and those with a genetic predisposition to keloid formation. Understanding these characteristics is essential for healthcare providers to diagnose and manage this condition effectively, ensuring that patients receive appropriate treatment and support.

For further management, it is advisable for patients to consult dermatologists who can provide tailored treatment options, including corticosteroid injections, laser therapy, or surgical interventions, depending on the severity of the keloids and the patient's overall health[14][15].

Acne keloid, classified under the ICD-10-CM code L73.0, is a specific type of keloid that arises from acne lesions, particularly affecting the nuchal area (the back of the neck). Understanding alternative names and related terms can enhance clarity in medical documentation and communication. Here’s a detailed overview of the terminology associated with this condition.

Alternative Names for Acne Keloid

1. Acne Keloidalis Nuchae: This is the most commonly used alternative name, specifically referring to keloids that develop in the nape of the neck due to acne. It emphasizes the location and the association with acne lesions[4].

2. Keloid Acne: This term is sometimes used interchangeably with acne keloid, although it is less common. It highlights the keloid formation as a result of acne[6].

3. Keloidal Folliculitis: This term may be used to describe the inflammatory process leading to keloid formation, particularly in the context of follicular disorders[5].

Related Terms

1. Follicular Disorders: Acne keloid falls under the broader category of follicular disorders, which includes various conditions affecting hair follicles. The ICD-10 code for other follicular disorders is L73, which encompasses a range of related conditions[5].

2. Keloids: While not specific to acne, keloids are a general term for raised scars that form due to excessive collagen production during the healing process. Acne keloid is a specific manifestation of this broader category[8].

3. Scarring Alopecia: In some cases, acne keloid can lead to hair loss in the affected area, which may be referred to as scarring alopecia. This term describes hair loss due to scarring of the scalp or skin[4].

4. Hypertrophic Scars: Although distinct from keloids, hypertrophic scars are another type of raised scar that can occur after acne lesions. They differ in that hypertrophic scars do not extend beyond the original wound margins, unlike keloids[8].

Conclusion

Understanding the alternative names and related terms for ICD-10 code L73.0 (Acne keloid) is essential for accurate diagnosis, treatment, and communication in clinical settings. Terms like "acne keloidalis nuchae" and "keloidal folliculitis" provide specificity, while broader terms like "keloids" and "follicular disorders" encompass the condition within a larger context. This knowledge aids healthcare professionals in effectively addressing and managing this skin condition.

Acne keloidalis nuchae, classified under ICD-10 code L73.0, is a specific type of keloid that primarily affects the nape of the neck and is associated with hair follicles. The diagnosis of this condition involves several criteria, which can be categorized into clinical evaluation, patient history, and diagnostic imaging or laboratory tests.

Clinical Evaluation

1. Physical Examination: A thorough examination of the affected area is essential. Clinicians look for:
   - Raised, firm lesions that are often itchy or tender.
   - The presence of hair follicles within the lesions, which may indicate a connection to acne or follicular occlusion.
   - The typical location of lesions, which is predominantly at the nape of the neck, but can also appear on the scalp or other areas.

2. Lesion Characteristics: The lesions are usually:
   - Hyperpigmented, especially in individuals with darker skin tones.
   - Firm and rubbery to the touch.
   - Often associated with a history of acne or folliculitis in the area.

Patient History

1. History of Acne: A significant history of acne or folliculitis in the affected area is often reported. This history can help differentiate acne keloidalis nuchae from other types of keloids or skin lesions.

2. Symptoms: Patients may report symptoms such as:
   - Itching or discomfort in the affected area.
   - Changes in the skin texture or appearance over time.

3. Risk Factors: Understanding risk factors is crucial. These may include:
   - Ethnicity: More common in individuals with darker skin.
   - Gender: More frequently observed in males, particularly those with short haircuts that may irritate the nape.

Diagnostic Imaging and Laboratory Tests

While imaging is not typically required for the diagnosis of acne keloidalis nuchae, in some cases, dermatologists may use:
- Dermatoscopy: This tool can help visualize the lesions more clearly and differentiate them from other skin conditions.
- Biopsy: In uncertain cases, a skin biopsy may be performed to confirm the diagnosis and rule out other conditions, such as dermatofibromas or other keloids.

Conclusion

The diagnosis of acne keloidalis nuchae (ICD-10 code L73.0) relies on a combination of clinical evaluation, patient history, and, if necessary, diagnostic tests. Recognizing the characteristic features of the lesions and understanding the patient's background are crucial for accurate diagnosis and subsequent management. If you suspect you have this condition, consulting a dermatologist for a comprehensive evaluation is recommended.

Acne keloid, classified under ICD-10 code L73.0, is a type of keloid that arises from acne lesions, typically characterized by raised, thickened scars that can be itchy or painful. The management of acne keloids involves a combination of medical and surgical approaches tailored to the individual patient's needs. Below, we explore the standard treatment options available for this condition.

Treatment Approaches for Acne Keloids

1. Topical Treatments

Topical therapies are often the first line of treatment for acne keloids. These may include:

• Silicone Gel Sheets: These are applied directly to the keloid and have been shown to help flatten and soften the scar over time. They work by hydrating the scar tissue and reducing collagen production[1].
• Corticosteroid Creams: Topical corticosteroids can help reduce inflammation and flatten keloids. They are often used in conjunction with other treatments for enhanced effectiveness[1][2].

2. Intralesional Injections

Intralesional corticosteroid injections are a common treatment for keloids. These injections can help reduce the size and symptoms of the keloid by decreasing inflammation and collagen production. Typically, injections are administered every few weeks until the desired results are achieved[1][3].

3. Surgical Options

Surgical excision may be considered for larger or more persistent keloids. However, surgery alone can sometimes lead to recurrence, so it is often combined with other treatments:

• Excision with Reconstruction: After excising the keloid, reconstructive techniques may be employed to minimize the appearance of the scar.
• Surgical Removal with Adjunctive Therapy: Following excision, treatments such as radiation therapy or corticosteroid injections may be used to prevent recurrence[2][4].

4. Laser Therapy

Laser treatments, including fractional laser and pulsed dye laser, can be effective in reducing the size and redness of keloids. These therapies work by targeting the blood vessels and collagen in the keloid tissue, promoting remodeling and flattening of the scar[3][5].

5. Cryotherapy

Cryotherapy involves freezing the keloid tissue, which can help reduce its size. This method is often used for smaller keloids and can be combined with other treatments for better outcomes[1][2].

6. Radiation Therapy

Post-surgical radiation therapy may be recommended to prevent keloid recurrence, particularly in patients with a history of aggressive keloid formation. This approach is typically reserved for cases where other treatments have failed[4][5].

7. Combination Therapies

A multimodal approach is often the most effective strategy for treating acne keloids. Combining treatments such as intralesional corticosteroids with laser therapy or surgical excision can yield better results and reduce the likelihood of recurrence[2][3].

Conclusion

The management of acne keloids (ICD-10 code L73.0) requires a comprehensive approach that may include topical treatments, intralesional injections, surgical options, laser therapy, cryotherapy, and radiation therapy. The choice of treatment should be individualized based on the size, location, and symptoms of the keloid, as well as the patient's medical history and preferences. Consulting with a dermatologist or a specialist in scar management is essential for developing an effective treatment plan tailored to the patient's needs.