Spontaneous keloids: a rare entity

Abstract

Purpose: Keloid scars are a benign fibroproliferative disorder resulting from tissue scar inflammation and abnormal collagen accumulation. Spontaneous keloids occur in the absence of an original traumatic condition, with reported cases associated with several genetic syndromes and a positive family history. This review aims to gather these existing cases, organizing them according to their possible etiology and used treatments. Methods: This review was conducted using PubMed and Web of Science, by using the query ("spontaneous keloids" OR "idiopathic keloids"). No type of filter was applied in the search due to the scarcity of published cases and rarity of this scarring disorder. All case reports and studies related to spontaneous keloids were included and all cases associated with trauma were excluded. In addition, two case reports of this type of keloids were also included. Results: It was possible to verify an association between spontaneous keloids and some genetic disorders. However, there were cases where individuals are completely healthy. Regarding the types of treatment used, it was shown that most keloids remain highly refractory to therapy with high rates of recurrence.

Conclusion: Idiopathic keloids are an extremely rare condition whose exact etiology is often difficult to determine, although in certain cases it is possible to verify a probable genetic influence on the origin of this type of scar. Despite its refractoriness, nowadays the combination of surgery and postoperative radiotherapy has shown excellent results.