Molecular mechanisms underlying keloid formation may involve disturbances in growth factor regulation, particularly TGF-B1, which promotes fibroblast proliferation and extracellular matrix synthesis during wound healing [12,25]. The emergence of keloids in the thoracic region in our patients, an area of high skin tension, also indicates the role of mechanical stress as an aetiologic factor. This evidence concerns the gene TGFB1 and keloid.