Acetylator phenotype in Iraqi patients with atopic dermatitis

Atopic dermatitis (AD) is a common multifactorial disease which has an itchy, recurrent, flexural and symmetrical eczematous eruption. There are reports that indicate that AD is associated with a predominantly slow acetylator status. This study was designed to determine the acetylator status in children with AD and compare it to a matched group of normal children. The study included 36 AD patients diagnosed clinically and 42 healthy controls. Detailed history was taken from the parents of each patient and disease severity was assessed using the Hanifin-Rajka scoring system. After overnight fast, each control subject and patient received a single oral dose of 50 mg of dapsone; a blood sample was collected after 3 hours and plasma separated for determination of dapsone and monoacetyldapsone by HPLC. The frequency of slow acetylators in the control group was 69.4 percent, and the frequency of rapid acetylators was 30.6 percent. The frequency of slow acetylators in AD patients was 72.2 percent and the frequency of rapid acetylators was 27.80 percent. There were no statistically significant differences between the control and AD patients groups. There was an association in AD patients between the acetylator status and family history of allergy as well as the severity assessed the Hanifin-Rajka scoring system. Although slow acetylators had lesions predominantly on the limbs, the distribution of lesions on the skin of rapid acetylators favored the face and neck. Although a slow acetylator status does not predispose to AD, it is associated with a different severity and distribution of the disease.