First, the precise biological roles of the identified biomarkers (AMPH/TNFRSF9) and therapeutic targets (IL6/HAS2) in keloid pathogenesis remain unvalidated through functional experiments; Second, the statistical power of our validation cohort may be constrained by its limited sample size; Third, while the diagnostic biomarkers demonstrate tissue-level specificity, their clinical utility requires further verification in non-invasive biofluids (e.g., serum) to assess detectability and correlation with disease severity. The gene discussed is TNFRSF9; the disease is keloid.