Keloidal collagen (Cosman et al., 1961; Santucci et al., 2001; Ogawa et al., 2009) vs. α-SMA and dermal nodules (Ehrlich et al., 1994; Huang et al., 2014) have often been cited as pathognomonic features for keloids or hypertrophic scars, respectively, but conflicting reports abound (Muir, 1990; Ehrlich et al., 1994; Santucci et al., 2001; Lee J. Y. Y. et al., 2004; Ogawa et al., 2009; Ali et al., 2010; Bux and Madaree, 2010; Huang et al., 2014). This evidence concerns the gene ACTA1 and keloid.