摘要Keloids are a common type of pathological scar as a result of skin healing, which are extremely diffi-cult to prevent and treat without recurrence. The patho-logical mechanism of keloids is the excessive prolif-eration of fibroblasts, which synthesize more extracel-lular matrices (ECMs), including type I/Ⅲ collagen (COL-1/3), mucopolysaccharides, connective tissue growth factor (CTGF, also known as cellular commu-nication network factor 2 (CCN2)), and fibronectin (FN) in scar tissue, mostly through the abnormal acti-vation of transforming growth factor-β(TGF-β)/Smads pathway (Finnson et al., 2013; Song et al., 2018). Genetic factors, including race and skin tone, are considered to contribute to keloid formation. The reported incidence of keloids in black people is as high as 16%, whereas white people are less affected. The prevalence ratio of colored people to white people is 5:1–15:1 (Rockwell et al., 1989;LaRanger et al., 2019). In addition, keloids have not been reported in albinism patients of any race, and those with darker skin in the same race are more likely to develop this disease (LaRanger et al., 2019). Skin melanocyte activity is significantly different among people with different skin tones. The more active the melanocyte function, the more melanin is produced and the darker the skin. Similarly, in the same individual, the inci-dence of keloids increases during periods when melano-cytes are active, such as adolescence and pregnancy. Keloids rarely appear in areas where melanocytes
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