The frequency of 21-alpha hydroxylase enzyme deficiency and related sex hormones in Iraqi healthy male subjects versus patients with acne vulgaris.

OBJECTIVES: To find out the frequency of nonclassical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency among Iraqi healthy male individuals versus male patients with acne vulgaris.

METHODS: This case-control study and single-center examination of hormone levels in a cohort of volunteers was conducted in the Department of Dermatology, Baghdad Teaching Hospital, and in the Physiological Chemistry Department of the College of Medicine, Baghdad University, Baghdad, Iraq, from September 2007 to February 2008.

RESULTS: The frequency of 21-hydroxylase enzyme deficiency in healthy male subjects was 1:43 (2.3%), while in male patients with acne vulgaris, this was 6:43 (13.95%). Serum 17-hydroxyprogesterone (OHP) levels were statistically and significantly elevated in male patients with acne vulgaris compared with healthy male controls (p=0.020). The serum total cortisol level was significantly reduced in patients with acne vulgaris in comparison with that of healthy controls (p=0.022).

CONCLUSIONS: These results support the necessity of inclusion of the 21-alpha hydroxylase enzyme activity (serum 17-OHP level) screening test in acne patients.