The role of anemia and vitamin D levels in acute and chronic telogen effluvium

Telogen effluvium (TE) is an abnormality of hair cycling. Vitamin D promotes hair follicle differentiation. The importance of vitamin D in hair growth is evident in patients with hereditary vitamin D receptor deficiency. The role of vitamin D in the pathogenesis of TE has not been investigated before. We investigated the role of vitamin D, ferritin, and zinc in the pathogenesis of TE. Materials and methods: We measured serum hemoglobin, ferritin, zinc, calcium, phosphate, parathormone, magnesium, 25 and 1,25-hydroxyvitamin D3, and bone alkaline phosphatase and thyroid stimulating hormone levels in 63 female patients and 50 control subjects. Twenty-nine of the TE patients were classified in the acute TE group and 34 were classified in the chronic TE groups. Results: Ferritin (acute TE; 17.0 ± 12.8, chronic TE; 19.6 ± 15.2, control; 35.5 ± 31.8, P < 0.001) and hemoglobin (acute TE; 12.7 ± 1.7, chronic TE; 13.3 ± 1.0, control; 14.2 ± 1.2, P < 0.0001) levels were significantly lower in the TE group than in the control group. However, 25-hydroxyvitamin D3 levels were significantly higher in the TE group than in the control group (acute TE; 18.5 ± 9.2, chronic TE; 24.4 ± 11.2, control; 15.6 ± 15.8, P < 0.01). Vitamin D levels increased gradually from control groups to acute and chronic TE groups. However, active D vitamin levels (1,25-hydroxyvitamin D3) were similar. Conclusion: Iron deficiency anemia seems to be the main triggering factor for the development of TE and the increase in serum 25-hydroxyvitamin D3 levels may be related to increased exposure to UV light due to TE.

The role of anemia and vitamin D levels in acute and chronic telogen effluvium

Telogen effluvium (TE) is an abnormality of hair cycling. Vitamin D promotes hair follicle differentiation. The importance of vitamin D in hair growth is evident in patients with hereditary vitamin D receptor deficiency. The role of vitamin D in the pathogenesis of TE has not been investigated before. We investigated the role of vitamin D, ferritin, and zinc in the pathogenesis of TE. Materials and methods: We measured serum hemoglobin, ferritin, zinc, calcium, phosphate, parathormone, magnesium, 25 and 1,25-hydroxyvitamin D3, and bone alkaline phosphatase and thyroid stimulating hormone levels in 63 female patients and 50 control subjects. Twenty-nine of the TE patients were classified in the acute TE group and 34 were classified in the chronic TE groups. Results: Ferritin (acute TE; 17.0 ± 12.8, chronic TE; 19.6 ± 15.2, control; 35.5 ± 31.8, P < 0.001) and hemoglobin (acute TE; 12.7 ± 1.7, chronic TE; 13.3 ± 1.0, control; 14.2 ± 1.2, P < 0.0001) levels were significantly lower in the TE group than in the control group. However, 25-hydroxyvitamin D3 levels were significantly higher in the TE group than in the control group (acute TE; 18.5 ± 9.2, chronic TE; 24.4 ± 11.2, control; 15.6 ± 15.8, P < 0.01). Vitamin D levels increased gradually from control groups to acute and chronic TE groups. However, active D vitamin levels (1,25-hydroxyvitamin D3) were similar. Conclusion: Iron deficiency anemia seems to be the main triggering factor for the development of TE and the increase in serum 25-hydroxyvitamin D3 levels may be related to increased exposure to UV light due to TE.

___

  • Harrison S, Sinclair R. Telogen effl uvium. Clin Exp Dermatol 2002; 27: 389-95. 2. Kligman A. Pathologic dynamics of human hair loss. I. Telogen effl uvium. Arch Dermatol 1961; 83: 175-98.
  • Dawber RPR, Simpson NB, Barth J. Diff use alopecia: endocrine, metabolic and chemical infl uences on the follicular cycle. In: Dawber RPR, eds. Diseases of the hair and scalp. 3rd ed. Oxford: Blackwell Science; 1997. p.123-50.
  • Scoggins RB, Harlan WR. Cutaneous manifestations of hyperlipidaemia and uraemia. Postgrad Med 1967; 41: 357-8. 5. Headington JT. Telogen effl uvium. New concepts and review. Arch Dermatol 1993; 129: 356-63. 6. Whiting DA. Chronic telogen effl uvium: increased scalp hair shedding in middle aged women. J Am Acad Dermatol 1996; 35: 899-906. 7. Sinclair R. Th ere is no clear association between low serum ferritin and chronic diff use telogen hair loss. Br J Dermatol 2002; 147: 982-4.
  • Reichrath J. Vitamin D and the skin: an ancient friend, revisited. Exp Dermatol 2007; 16: 618-25.
  • Zlotogorski A, Hochberg Z, Mirmirani P, Metzker A, Ben- Amitai D, Martinez-Mir A, et al. Clinical and pathologic correlations in genetically distinct forms of atrichia. Arch Dermatol 2003; 139: 1591-6.
  • Vegesna V, O’Kelly J, Uskokovic, M, Said J, Lemp N, Saitoh T et al. Vitamin D3 analogs stimulate hair growth in nude mice. Endocrinology 2002; 143: 4389-96.
  • Gautam CS, Saha L, Sekhri K, Saha PK. Iron defi ciency in pregnancy and the rationality of iron supplements prescribed during pregnancy. Medscape J Med 2008; 10: 283.
  • Trost LB, Bergfeld WF, Calogeras E. Th e diagnosis and treatment of iron defi ciency and its potential relationship to hair loss. J Am Acad Dermatol 2006; 54: 824-44.
  • Olsen EA. Iron defi ciency and hair loss: the jury is still out. J Am Acad Dermatol 2006; 54: 903-6.
  • Kantor J, Kessler LJ, Brooks DG, Cotsarelis G. Decreased serum ferritin is associated with alopecia in women. J Invest Dermatol 2003; 121: 985-8.
  • Sinclair RD. Diff use hair loss. Int J Dermatol 1999; 38: 8-18.
  • Olsen EA. Th e midline part: An important physical clue to the diagnosis of androgenetic alopecia in women. J Am Acad Dermatol 1999; 40: 106-9.
  • Shrivastava SB. Diff use hair loss in an adult female: Approach to diagnosis and management. Indian J Dermatol Venereol Leprol 2009; 75: 20-8.
  • Deloche C, Bastien P, Chadoutaud S, Galan P, Bertrais S, Hercberg S et al. Low iron stores: a risk factor for excessive hair loss in non-menopausal women. Eur J Dermatol 2007; 17: 507- 12.
  • Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol 2002; 27: 396-404.
  • Bregy A, Trueb RM. No association between serum ferritin levels >10 microg/l and hair loss activity in women. Dermatology 2008; 217: 1-6.
  • Rushton DH, Ramsey ID, James KC, Norris MJ, Gilkes JJ. Biochemical and trichological characterization of diff use alopecia in women. Br J Dermatol 1990; 123: 187-97.
  • Alhaj E, Alhaj N, Alhaj NE. Diff use alopecia in a child due to dietary zinc defi ciency. Skinmed 2007; 6: 199-200.
  • Ead RD. Oral zinc sulphate in alopecia areata – a double blind study. Br J Dermatol 1981; 104: 483-4.
  • Arnaud J, Beani JC, Favier AE, Amblard P. Zinc status in patients with telogen defl uvium. Acta Derm Venereol (Stockh) 1995; 75: 248-9.
  • Clemens TL, Adams JS, Horiuchi N, Gilchrest BA, Cho H, Tsuchiya Y et al. Interaction of 1,25-dihydroxyvitamin-D3 with keratinocytes and fi broblasts from skin of normal subjects and a subject with vitamin-D dependent rickets, type II: a model for study of the mode of action of 1,25-dihydroxyvitamin D3. J Clin Endocrinol Metab 1983; 56: 824-30.
  • Ramot Y, Paus R, Tiede S, Zlotogorski A. Endocrine controls of keratin expression. BioEssays 2009; 31: 389-99.
  • Panda DK, Miao D, Tremblay ML, Sirois J, Farookhi R, Hendy GN et al. Targeted ablation of the 25-hydroxyvitamin D 1α-hydroxylase enzyme: Evidence for skeletal, reproductive, and immune dysfunction. Proc Natl Acad Sci USA 2001; 98: 7498-503.
  • Slominski A, Paus R, Costantino R. Diff erential expression and activity of melanogenesis-related proteins during induced hair growth in mice. J Invest Dermatol 1991; 96: 172-9.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Treadmil egzersiz testine hipertansif yanıtı olan hastalarda ventrikül fonksiyonları, aortun elastik özellikleri ve endotel fonksiyonları

Fethi KILIÇASLAN, Bekir Sıtkı CEBECİ, Ata KIRILMAZ, Oben BAYSAN, Mehmet YOKUŞOĞLU, Rifat Eralp ULUSOY

Lipid profi le alterations and oxidative stress in patients with preeclampsia: role of black tea extract on disease management

Ekambaram PADMINI, Munuswamy USHA RANI

Comparison of results in two acoustic analysis programs: Praat and MDVP

Mehmet Akif KILIÇ, Mustafa Asım ŞAFAK, Haldun OĞUZ

The effects of local anaesthesia with bupivacaine and botulinum toxin-A after thoracotomy on stress hormone levels

Makbule ERGİN, Ali YEGİNSU, İsmail Kürşat GÜRLEK

Physician compliance with American Heart Association guidelines for prevention of bacterial endocarditis in dental procedures

Banu KOYUNCU ÖZVERİ, Servet KANDEMİR, Fatma Bahar SEZER, Tayfun GÜNBAY

An analysis of HER-2/neu gene status in invasive ductal carcinomas using immunohistochemistry and fl uorescence in situ hybridization

Reşit Doğan KÖSEOĞLU, Jülide Saliha CAFERLER, Ahmet MÜSLEHİDDİNOĞLU, Pervin DÜRER, Ünal ERKORKMAZ, Yavuz Hakan ÖZÖN

Clinical signifi cance and staphylococcal cassette chromosome mec (SCCmec) characterization of coagulase-negative staphylococci isolated from blood cultures

Orhan BEDİR, Gürkan MERT, Ahmet Celal BAŞUSTAOĞLU, Abdullah KILIÇ

Distribution of congenital heart disease in Turkey*

Serdar KULA, Ayhan ÇEVİK, Fatma Rana OLGUNTÜRK, Fatma Sedef TUNAOĞLU, Ayşe Deniz OĞUZ, Mustafa Necmi İLHAN

The seroprevalence of Anaplasma phagocytophilum in humans from two different climatic regions of Turkey and its co-seroprevalence rate with Borrelia burgdorferi

Turabi GÜNEŞ, Ömer POYRAZ, Nergiz Hacer TURGUT, Mehmet ATAŞ

Knowledge discovery for the treatment of bacteria affecting the liver

Pınar YILDIRIM, Kağan ÇEKEN, Osman SAKA