This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This proposal, "Keloids: Epidemiologic and Genetic Studies," would conduct a novel genetic epidemiology study on keloids, which affect more than ten million patients in America. Dark-skinned ethnic groups have been reported to develop keloids at a higher incidence rate than light-skinned populations, ranging from 2:1 for black versus 19:1 for white. Despite this worldwide health disparity, which afflicts 30 percent of Americans, or nearly 75 million people, a genetic epidemiology study on keloids is lacking. Keloids have been reported to be both familial and sporadic, with familial inheritance ranging from 1.9 percent to 3.4 percent. However, in the dermatology clinic at King/Drew Medical Center, the number of genetic cases seems higher, according to a survey of 80 patients who visited the clinic in a 12-month timeframe (Kelly et al, 2005). We hypothesize that environmental and genetic risk factors are associated with a higher incidence rate of keloid formation in this patient population. As such, the following specific aims are proposed: Aim 1: To identify keloid risk factors including shared environmental exposures (e.g. smoking, diet, alcohol intake, etc) and clinical measures [e.g. body mass index (BMI), blood pressure (BP), age, sex, etc]. Aim 2: To identify the genetic risk factors for familial keloids. A series of in depth epidemiologic surveys with appropriate standardization will be conducted on all keloid patients and as many of their family members with keloids as possible. Data on the patients will be collected in one visit to the Clinical Research Center, consisting of an interview (questionnaires), a physical examination, and clinical laboratory measures. Genetic and epidemiological methods will be used to evaluate the familial aggregation of keloids. When available, clinically obtained tissue biopsies will also be evaluated if the patients give their consent. The effects of shared environmental exposures (e.g., smoking, diet, alcohol intake and physical activity) and clinical measures (e.g., BMI, BP, age, sex, etc) will be analyzed to identify associated risk factors. The results of this study should not only lead to improved prevention and therapy for keloids, but also will create a unique window to provide more definitive information about wound healing and fibrosing diseases.