A Case of Multiple Spontaneous Keloid Scars

Abstract

Keloid scars result from an abnormal healing response to cutaneous injury or inflammation that extends beyond the borders of the original wound. Spontaneous keloid scars forming in the absence of any previous trauma or surgical procedure are rare. Certain syndromes have been associated with this phenomenon, and few reports have discussed the evidence of single spontaneous keloid scar, which raises the question whether they are really spontaneous. Here, we present a 27-year-old mentally retarded single female with orbital hypertelorism, broad nasal bridge, repaired cleft lip and high-arched palate who presented with progressive multiple spontaneous keloid scars in different parts of her body which were confirmed histologically by the presence of typical keloidal collagen. This report supports the fact that keloid scars can appear spontaneously and are possibly linked to a genetic factor. Furthermore, it describes a new presentation of spontaneous keloid scars in the form of multiple large lesions in different sites of the body.

Spontaneous Keloids: A Literature Review

“…Later in life, he developed a keloid over the surgical insertion site of a pacemaker [15]. We also reported that a syndromic 27-year-old female who has mental retardation along with orbital hypertelorism, a broad nasal bridge, high arched palate, and repaired cleft lip developed sudden widespread extensive keloids over multiple sites of her body [16].…”

Assessing keloid recurrence following surgical excision and radiation

“…They may result from a cutaneous injury to the reticular dermis [ 2 ], such as surgery or mechanical trauma. Rarely, they may occur spontaneously [ 3 ]. Although the mechanism of keloid formation is not known with certainty, they are characterized by increased fibroblasts and collagen formation, new blood vessel growth and the presence of upregulated proinflammatory factors [ 2 , 4 ].…”

“…Surgical excision of keloids as sole therapy is associated with recurrence rates as high as 80% [ 3 ], 65–99% [ 7 ] and 45–100% [ 8 ]. Consequently, a wide range of treatments have been used to treat keloid scars, including silicon sheeting, topicals, intralesional corticosteroid injections, cryotherapy, lasers and post-keloidectomy radiation therapy [ 4 , 9 , 10 ].…”

Comparison of the Effectiveness of Phosphorus 32 Application and 10 Mg/Cc Triamcinolone Acetonide Intralesional Injection on Keloid

“…1,2 These fibrous growths result from a connective tissue response to trauma, burns, surgery, or inflammation, and seems occasionally occur spontaneously. 3,4 Psychosocial problems often occur due to cosmetic issues and contracture as complications from keloid.…”

“…Basic fibroblast growth factor (bFGF) inhibits collagen production and stimulates collagen degradation. 1 A real challenge is faced in the therapy of keloid since no treatment is highly effective for this condition to date. There are several therapies for the treatment of keloid, such as laser, silicone gel, excision, interferon, corticosteroid intralesional injection, radiation, cryotherapy, and 5-fluorouracil injection, or combination.…”