Bilik Leyla, Kokcam Ibrahim, Esen Mustafa
Department of Dermatology and Venereal Diseases, Mardin State Hospital, Mardin, Turkiye.
Department of Dermatology and Venereal Diseases, Adiyaman University Training and Research Hospital, Adiyaman, Turkiye.
North Clin Istanb. 2024 Jan 29;11(1):38-44. doi: 10.14744/nci.2023.33269. eCollection 2024.
OBJECTIVE: Telogen effluvium (TE) is a type of alopecia that is frequently seen in women. Among factors resulting in hair loss, many reasons such as endocrine diseases, nutrition disorders, stress, anemia, low ferritin levels, vitamin B12 deficiency, and thyroid diseases are found. A digital phototrichogram is one of the non-invasive methods of diagnosis in the evaluation of alopecia. In this study, it was aimed to compare biochemical parameters of female patients with diffuse hair loss with phototrichogram findings. METHODS: 108 female patients with diffuse hair loss were included in the study. Patients were divided into two groups: acute and chronic TE, and a hair pull test was applied. Total blood count, blood biochemistry, iron, iron binding capacity, ferritin, thyroid stimulating hormone (TSH), sT3, sT4, folic acid, and vitamin B12 levels were examined. The telogen/anagen ratios and hair densities of patients were determined with a phototrichogram. RESULTS: The serum biochemical parameters (aspartate aminotransferase, alanine aminotransferase, urea, creatinine), TSH, sT3, sT4, and folic acid levels of patients were within normal limits. Telogen ratio, anagen ratio, hair density, number of shed hairs, family history, blood ferritin, TSH, and vitamin B12 levels were found to be similar between groups having acute and chronic TE. In our study, while mean anagen and telogen ratios with trichoscan were similar to literature data, no statistically significant correlation was determined between patients' ages and examined trichoscan findings (p>0.05). The hair pull test positivity of patients with chronic TE was higher compared to patients with acute TE (p<0.05). In patients with positive hair pull tests, the telogen ratio and hair density were found to be higher. In the group with <40 ng/mL ferritin level, the mean telogen ratio was detected to be significantly higher than the mean anagen ratio (p<0.05). No significant correlation was determined between vitamin B12 and TSH levels in patients and phototrichogram findings (p>0.05). CONCLUSION: The findings of this study showed that ferritin has an important role in diffuse hair loss, and the phototrichogram method is an auxiliary method for the physician in the diagnosis of TE.
目的：休止期脱发（TE）是一种常见于女性的脱发类型。在导致脱发的因素中，发现了许多原因，如内分泌疾病、营养失调、压力、贫血、铁蛋白水平低、维生素B12缺乏和甲状腺疾病等。数码光镜毛发分析是评估脱发的非侵入性诊断方法之一。本研究旨在比较弥漫性脱发女性患者的生化参数与光镜毛发分析结果。 方法：108例弥漫性脱发女性患者纳入本研究。患者分为两组：急性和慢性TE组，并进行拔毛试验。检测全血细胞计数、血液生化、铁、铁结合能力、铁蛋白、促甲状腺激素（TSH）、sT3、sT4、叶酸和维生素B12水平。用光镜毛发分析测定患者的休止期/生长期比率和毛发密度。 结果：患者的血清生化参数（天冬氨酸转氨酶、丙氨酸转氨酶、尿素、肌酐）、TSH、sT3、sT4和叶酸水平均在正常范围内。发现急性和慢性TE组之间的休止期比率、生长期比率、毛发密度、脱发数量、家族史、血铁蛋白、TSH和维生素B12水平相似。在我们的研究中，虽然用毛发扫描得到的平均生长期和休止期比率与文献数据相似，但患者年龄与所检测的毛发扫描结果之间未确定有统计学意义的相关性（p>0.05）。慢性TE患者的拔毛试验阳性率高于急性TE患者（p<0.05）。在拔毛试验阳性的患者中，休止期比率和毛发密度较高。在铁蛋白水平<40 ng/mL的组中，检测到平均休止期比率显著高于平均生长期比率（p<0.05）。患者的维生素B12和TSH水平与光镜毛发分析结果之间未确定有显著相关性（p>0.05）。 结论：本研究结果表明铁蛋白在弥漫性脱发中起重要作用，光镜毛发分析方法是医生诊断TE时的一种辅助方法。
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