In terms of fibrotic signalling pathways, several pathways are involved in keloid formation, including the mitogen-activated protein kinase (MAPK), insulin-like growth factor-I (IGF-I), integrin, and TGF-β1/Smad pathways, of which the TGF-β1/Smad pathway is thought to be the most critical [13]. This evidence concerns the gene TGFB1 and keloid.