Durusu Turkoglu Irem Nur, Turkoglu Aziz Kaan, Soylu Seçil, Gencer Gülcan, Duman Rümeysa
Department of Dermatology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
Internal Medicine Clinic, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey.
J Cosmet Dermatol. 2024 Dec;23(12):4277-4284. doi: 10.1111/jocd.16512. Epub 2024 Aug 6.
The etiology of telogen effluvium (TE) includes situations that may cause physiological stress, surgical trauma, inflammatory, infectious, iatrogenic causes, medications and nutritional deficiencies. TE has been associated with iron deficiency, vitamin B12 deficiency and thyroid diseases. In recent years, the use of over-the-counter food supplements containing vitamins and minerals such as biotin, vitamin D, zinc (Zn), copper (Cu) and selenium (Se) has been increasing in TE patients. The aim of this study is to investigate whether there are differences in nutritional status, vitamin and mineral levels by comparing individuals with TE and a control group.
This case-control study included 90 female patients diagnosed with chronic telogen effluvium (CTE), and 90 female controls volunteered to participate in the study who consulted for reasons other than TE. Both groups aged 18 and over and applied to dermatology polyclinic between 01.09.2022 and 01.09.2023. A detailed anamnesis was taken from all patients, a hair pull test was performed, and TE was diagnosed after a dermoscopic examination was performed on all areas of the scalp. Then, serum vitamin D, Zn, Cu, Se levels and biotin levels in serum and urine were measured. Hemoglobin (Hb), ferritin, vitamin B12 and thyroid function tests were retrospectively scanned from the hospital database.
It was determined that Zn levels were significantly lower in CTE patients than in controls. Se levels were found to be significantly higher in patients than in controls. There was no difference in Hb, ferritin, vitamin B12, thyroid function tests, vitamin D, Cu levels, serum and urine biotin levels between the two groups. Zn, Cu/Zn and Se levels were found to have statistically significant diagnostic performance in predicting the diagnosis of CTE. Cu/Zn ratio and Se value were found to be significant predictors of CTE.
This study shows us that nutritional deficiencies are not as common as thought in patients diagnosed with TE. Other causes that may cause TE should be investigated by a detailed anamnesis and a good physical examination. After all, tests for suspected conditions should be performed and individualized treatment options should be created for each patient.
休止期脱发（TE）的病因包括可能导致生理应激、手术创伤、炎症、感染、医源性因素、药物及营养缺乏的情况。TE与缺铁、维生素B12缺乏及甲状腺疾病有关。近年来，患有TE的患者使用含有生物素、维生素D、锌（Zn）、铜（Cu）和硒（Se）等维生素和矿物质的非处方食品补充剂的情况日益增多。本研究的目的是通过比较TE患者和对照组个体，调查营养状况、维生素和矿物质水平是否存在差异。
本病例对照研究纳入了90例诊断为慢性休止期脱发（CTE）的女性患者，以及90例因TE以外原因前来咨询并自愿参与研究的女性对照者。两组年龄均在18岁及以上，于2022年9月1日至2023年9月1日期间就诊于皮肤科门诊。对所有患者进行了详细的病史采集，进行了拔毛试验，并在对头皮所有区域进行皮肤镜检查后诊断为TE。然后，测量血清维生素D、Zn、Cu、Se水平以及血清和尿液中的生物素水平。从医院数据库中回顾性扫描血红蛋白（Hb）、铁蛋白、维生素B12和甲状腺功能检查结果。
确定CTE患者的Zn水平显著低于对照组。发现患者的Se水平显著高于对照组。两组之间的Hb、铁蛋白、维生素B12、甲状腺功能检查、维生素D、Cu水平、血清和尿液生物素水平无差异。发现Zn、Cu/Zn和Se水平在预测CTE诊断方面具有统计学显著的诊断性能。发现Cu/Zn比值和Se值是CTE的显著预测指标。
本研究表明，诊断为TE的患者中营养缺乏并不像认为的那么常见。应通过详细的病史采集和良好的体格检查来调查可能导致TE的其他原因。毕竟，应对疑似病症进行检查，并为每位患者制定个体化的治疗方案。
