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Multiple cytokines and inflammatory factors participate in keloid formation, such as transforming growth factor 1(TGF-1), vascular endothelial growth factor (VEGF), interleukin (IL)-1, IL-6, and IL-8, as well as increased matrix metalloproteinases (MMP S ), which may promote fibroblast proliferation and migration, the inflammatory response, and collagen production 2,3,4