The scars can be painful or pruritic, and severe infections can occur. In early cases, there are papules, pustules and abscesses. These lesions are gradually replaced by fibrous nodules. The histopathology shows a perifollicular infiltrate composed of lymphoid cells, neutrophils, histiocytes and plasma cells. Older lesions show chronic granulation tissue.
Fibrosis is seen as healing takes place.
Various treatments have been used with some success in less severe cases. These include electrodesiccation, intralesional steroids, antibiotics and radiation treatments. Severe cases may require excision and skin grafting. Because the grafts may form keloids, Unger1 has proposed a test graft session. He takes a 4 mm graft and implants it near the operative site.