ACTA1 and keloid: An extensive review by Jumper et al. (2015) on the histopathology of keloid scars has reiterated most of the aforementioned findings, and further emphasizes the following as most frequently occurring and therefore most discerning features of keloid scars: a thickened, flattened epidermis; a tongue-like advancing edge in the dermis; haphazard, thick, hyalinized collagen bundles as the predominant dermal feature, with subsequent loss of the papillary-reticular boundary; increased dermal cellularity; signs of inflammation; and variable α-SMA expression.