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Spontaneous symmetrical giant keloids at the bilateral labia majora: a case report
WenChao Zhang1, Xiaojun Wang1, Jiuzuo Huang1
1Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.
Insights
Spontaneous giant keloids on the labia majora are rare. This case highlights abnormal inflammation
Area of Science:
- Dermatology
- Gynecology
- Pathology
Background:
- Keloids result from dysregulated wound healing and collagen metabolism.
- Spontaneous keloids, without prior trauma, are uncommon.
Observation:
- A 59-year-old woman presented with bilateral labia majora neoplasms.
- Symptoms included 3-year persistent swelling and >10-year history of pruritus, pain, and folliculitis.
Findings:
- Diagnosis confirmed as spontaneous symmetrical giant keloids of the labia majora.
- Surgical resection with direct closure and inguinal flap reconstruction, followed by adjuvant radiotherapy, was performed.
- No recurrence observed at 1-year follow-up.
Implications:
- This is the first reported case of spontaneous symmetrical giant keloids in this location.
- Highlights the role of abnormal inflammation in keloid pathogenesis.
- Inguinal flap repair offers functional and aesthetic benefits for vulvar defects with minimal mobility impact.
Abstract:
Keloids are caused by an imbalance between collagen matrix decomposition and production during wound repair. Spontaneous keloids are a rare type of keloid that arise without a significant history of trauma or surgery. We herein report a case involving a 59-year-old woman with symmetric neoplasms at the bilateral labia majora that had persisted for about 3 years and a >10-year history of pruritus and pain at the bilateral labia majora with folliculitis. The bilateral labia majora gradually swelled and lost their normal physiological morphology. The patient was diagnosed with keloids. Under general anesthesia, the keloids were resected. The right incision was sutured directly and the left was closed using an inguinal flap. Adjuvant radiotherapy was administered after the surgery. No recurrence of the keloids was observed at the 1-year follow-up, and the patient was satisfied with the appearance of the vulvar region. This is the first report of spontaneous symmetrical giant keloids at the bilateral labia majora, and it emphasizes the importance of the effect of abnormal inflammation on keloid formation. Repairing genital defects using an inguinal flap has only a minor effect on the patient's postoperative movement, and an ideal vulvar appearance can be achieved.
