ACTA1 and keloid: Accumulative studies reported that the formation of the keloid was closely associated with the CD34−/α-SMA+/p16 + phenotype along with strong immunoreactivity for p16 (Limandjaja et al., 2020), abnormal signaling regulation pathways in the fibroblast such as noncoding RNA (Gao et al., 2022; Kuai and Jian, 2022; Zhu et al., 2022) or exosome secretion (Shen et al., 2022).