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Chronic tension is implicated in their growth, but the exact pathology remains unclear. This study investigated the increased expression of molecules responsible for sensing pressure in keloids compared with lymphedema, which is also a non\u2010tumorous fibroproliferative disease caused by another etiology. Higher expression levels of\n                    <jats:italic>COL1A2<\/jats:italic>\n                    ,\n                    <jats:italic>PIEZO2<\/jats:italic>\n                    , and\n                    <jats:italic>POSTN<\/jats:italic>\n                    were observed in the keloid group compared with the lymphedema group.\n                    <jats:italic>PIEZO2<\/jats:italic>\n                    expression levels showed a strong correlation with both\n                    <jats:italic>COL1A2<\/jats:italic>\n                    (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.9252, 95% CI 0.8474\u20130.9641,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and\n                    <jats:italic>POSTN<\/jats:italic>\n                    (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.9118, 95% CI 0.8213\u20130.9575,\n                    <jats:italic>p\u2009&lt;<\/jats:italic>\n                    \u20090.001). Additionally,\n                    <jats:italic>PIEZO2<\/jats:italic>\n                    expression levels were significantly higher in recurrent keloids than in non\u2010recurrent keloids (3,032.5\u2009\u00b1\u20091,090.2 versus 1,241.9 \u00b1\u2009860.7,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.032). Analysis of gene expression at the single\u2010cell level found upregulation of\n                    <jats:italic>PIEZO2<\/jats:italic>\n                    in vascular and lymphatic endothelial cells, and a subgroup of fibroblasts. Additionally,\n                    <jats:italic>COL1A1<\/jats:italic>\n                    ,\n                    <jats:italic>COL1A2<\/jats:italic>\n                    ,\n                    <jats:italic>COL3A1<\/jats:italic>\n                    , and\n                    <jats:italic>POSTN<\/jats:italic>\n                    expression was also increased in the fibroblast subgroup. Furthermore, in fibroblasts with high\n                    <jats:italic>PIEZO2<\/jats:italic>\n                    expression, extracellular matrix collagen production signaling was augmented. Histological analysis confirmed the presence of PIEZO2\u2010positive cells in the perivascular stroma active area of keloid tissue, together with inflammatory cells. Therefore, since PIEZO2\u2010positive cells are highly expressed specifically in keloids and are deeply involved in their recurrence and activity, we propose that the pathogenesis of keloids is constructed by PIEZO2\u2010positive cells. \u00a9 2025 The Author(s).\n                    <jats:italic>The Journal of Pathology<\/jats:italic>\n                    published by John Wiley &amp; Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.\n                  <\/jats:p>","DOI":"10.1002\/path.6455","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T15:45:09Z","timestamp":1753976709000},"page":"105-119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Increased expression of the\n                    <scp>PIEZO2<\/scp>\n                    mechanoreceptor in fibroblasts and endothelial cells within the lymphatic and vascular vessels of 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