Background
The role of genetic factors in keloids is affirmed by the fact that keloids have been shown to occur among members of the same family.

Objective
To determine whether there is any association between patients’ blood group and HLA sub-types to keloids and keloid recurrence.

Design
A prospective longitudinal study.

Setting
Kenyatta National Hospital between August 2018 and July 2020.

Subjects/Participants
Patients with keloids and a control group of patients managed for other surgical conditions with no keloids. Blood was taken from each patient and analyzed for blood group and HLA sub-types using the sequence specific primer genotyping. Data were summarized and analyzed using Student’s t-test and Bonferroni correction. Probability significance was set at 0.05.

Results
A total of 90 patients with keloids and 59 in the control group were followed up in the study. The male to female ratio was 1:2. The most common blood group for both groups was blood group O (51.3% and 49.2%), followed by groups A and B respectively. Patients with keloids had significantly higher positive alleles of HLADQA101 and HLADQB106. There was also an association between blood group A and keloid recurrence.

Conclusion
This study demonstrates a significant difference in some HLA sub-types and blood groups between patients who form keloids and those who do not, indicating a possible role of patient genetics and immune factors in keloid pathogenesis and severity.