Excessive collagen formation during the remodeling phase of wound healing can result in a keloid or hypertrophic scar.
Keloids and hypertrophic scars consist of connective tissue rich in fibroblasts, myofibroblasts, and bundles of collagen fibers that are arranged in a disorganized fashion in keloids and in parallel in hypertrophic scars.
PDGF and transforming growth factor-beta (TGF-beta) plays a major role during proliferative phase
If persistently elevated -> hypertrophic or disfiguring scars
In addition, the fibroblasts in hypertrophic scars often have altered TGF-beta signaling due to increased TGF-beta receptor expression.