Prevalence of acne keloidalis nuchae in football players☆,☆☆
Section snippets
MATERIAL AND METHODS
A total of 453 subjects, all male, were recruited from eight different groups: members of four local public high school football teams (grades 9 through 12, n = 135), collegiate football players from two state universities and the National Football League (NFL) scouting combine (n = 245),*
RESULTS
A total of 453 football players between the ages of 14 and 27 were examined. Players at or below the twelfth grade (level I) numbered 135. Players above the twelfth grade (level II) numbered 318 (Table I) . A total of 64 players had positive findings, and all completed evaluable questionnaires.
The prevalence of either nuchal AM or AKN was 14.1% for the entire group. The prevalence of nuchal AM in the absence of AKN was 5.9% for all players (5.5% in blacks, 6.6% in whites). The prevalence of AKN
DISCUSSION
In football players, nuchal AM has been noted to precede AKN. 5, 7 The padding within the football helmet provides an ideal environment for AM to develop. Heat and perspiration are trapped, Staphylococcus albus and Propionibacterium acnes are present, and friction and irritation are continuous. 6 Adding the increased sebaceous activity of this age group and their increased physical and emotional stress, football players would appear to be a population at increased risk for AM and possibly AKN.
CONCLUSION
We are the first to report the prevalence of AKN among a population at increased risk for this disease. Among 453 players examined, AKN was found exclusively among blacks. In addition to race, increased level of play was positively associated with the development of AKN. In the absence of a control population, we cannot state with confidence that this is not a phenomena associated with increased age such as increasing hair coarseness. It may simply be a matter of chance, that is, the older a
Acknowledgements
In addition to the players and coaches who participated in this study, we would like to thank the following for their help: Kenneth Dawes, MD, Brian Williams, MD, Leroi Keyes, MD, and Mary Morgan.
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