Malkud Shashikant
Senior Resident, Department of Dermatology, Venereology and Leprosy, ESIC Medical College Kalaburagi, Karnataka, India .
J Clin Diagn Res. 2015 Aug;9(8):WC01-4. doi: 10.7860/JCDR/2015/14089.6170. Epub 2015 Aug 1.
Diffuse hair loss is a common complaint encountered by dermatologists in their daily clinical practice. Hair loss in women is a distressing condition. Various underlying factors individually or in combination contribute to the pathogenesis.
To determine causes of diffuse hair loss in women and to find the association between probable causes and relevant laboratory parameters, wherever applicable.
One hundred and eighty women with diffuse hair loss were included in the study. Detailed history and clinical examination including hair pull test and hair microscopy were done in all study subjects. Specific laboratory investigations for determining iron deficiency anaemia, thyroid dysfunction and parasitic infestation were done.
Among 180 patients, 116 (64.44%) had telogen effluvium, 28 (15.55%) had CTE, 21 (11.66%) had FPHL and 1 (0.55%) had AE. Fourteen patients (7.77%) had more than one aetiological diagnosis of diffuse hair loss. TE was the commonest type of diffuse hair loss. Incidence of TE and FPHL were highest in the age group of 21-30 years, whereas CTE in 30-40 years. Psychological stress and iron deficiency anaemia were the most common underlying aetiological factors for TE, which is statistically significant (p<0.05). Out of 130 patients with TE, more than one aetiological factor was recorded in 10 cases whereas in 32 cases probable aetiological factors could not be elicited from history. Most cases of CTE were idiopathic. No significant relationship was observed between CTE, haemoglobin level and serum ferritin level. Out of 35 patients with FPHL, low haemoglobin level was observed in 6/20 (30%) and low serum ferritin level in 14/17 (82.35%).
Diffuse hair loss is a multifactorial condition. A detailed history, thorough clinical examination and appropriate investigations help to identify the causative factors and treat them accordingly.
弥漫性脱发是皮肤科医生在日常临床实践中常见的主诉。女性脱发是一种令人苦恼的病症。各种潜在因素单独或共同作用导致其发病机制。
确定女性弥漫性脱发的原因,并在适用的情况下找出可能的原因与相关实验室参数之间的关联。
180名弥漫性脱发女性纳入本研究。对所有研究对象进行详细的病史询问和临床检查,包括拔发试验和毛发显微镜检查。进行了用于确定缺铁性贫血、甲状腺功能障碍和寄生虫感染的特定实验室检查。
180例患者中,116例(64.44%)患有休止期脱发,28例(15.55%)患有慢性休止期脱发,21例(11.66%)患有女性型雄激素性脱发,1例(0.55%)患有斑秃。14例患者(7.77%)有不止一种弥漫性脱发的病因诊断。休止期脱发是弥漫性脱发最常见的类型。休止期脱发和女性型雄激素性脱发的发病率在21 - 30岁年龄组最高,而慢性休止期脱发在30 - 40岁年龄组最高。心理压力和缺铁性贫血是休止期脱发最常见 的潜在病因,具有统计学意义(p<0.05)。在130例休止期脱发患者中,10例记录了不止一种病因,而32例从病史中未发现可能的病因。大多数慢性休止期脱发病例为特发性。未观察到慢性休止期脱发与血红蛋白水平和血清铁蛋白水平之间的显著关系。在35例女性型雄激素性脱发患者中,20例中有6例(30%)血红蛋白水平低,17例中有14例(82.35%)血清铁蛋白水平低。
弥漫性脱发是一种多因素病症。详细的病史、全面的临床检查和适当的检查有助于识别病因并相应地进行治疗。