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HAİR LOSS: WHO NEEDS LABORATORY INVESTIGATIONS?

Year 2020, Volume: 21 Issue: 1, 24 - 29, 16.01.2020
https://doi.org/10.18229/kocatepetip.536112

Abstract

OBJECTIVE: The aim of this study was to emphasize the importance of history and physical examination in patients presenting with hair loss, and to determine in which patients laboratory tests are necessary.

MATERIAL AND METHODS: 622 patients with hair loss complaint, who applied to Karabük Training and Research Hospital Dermatology Clinic between April 2017 and April 2018 were included. The required complete blood count, serum glucose, vitamin B12, vitamin D, TSH, serum iron, iron binding capacity, and ferritin results and accompanying diseases were recorded in the patients diagnosed with any hair loss in the hospital database.

RESULTS: Of the 622 patients, 339 (55%) were female and 283 (45%) were male. 321 (51%) of the patients had diffuse hair loss, 210 of them (33%) alopecia areata, 72 of them (12%) were diagnosed with androgenetic alopecia. The number of patients with scarring hair loss complaints was 14, and the number of patients with tinea capitis diagnosed with hair loss complaints was 5. Iron deficiency anemia was detected in 10% of female patients who complained of diffuse hair loss and Vitamin D deficiency was detected in 30% of patients. It was 34 in scarring alopecia patients. There were no abnormal laboratory findings in women with alopecia areata, androgenetic alopecia and scatricial alopecia except iron deficiency seen in 10% of women with diffuse hair loss.No abnormal laboratory findings could be associated with hair loss in all male patients presenting with hair loss.

CONCLUSIONS: Our findings showed that laboratory examination of patients who presented with hair loss complaints did not give information about the cause except for selected patients. It will be a time and economic impact of not wanting unnecessary tests with a good anamnesis.


References

  • 1. Mubki T, Rudnicka L, Olszewska M, Shapiro J. Evaluation and diagnosis of the hair loss patient: part I. History and clinical examination. J Am Acad Dermatol 2014;71(3):415.e1-415.e15.
  • 2. Jose N, Isac CM, Kunjumani S, Vilasinlamma L. Sarcomatoid lung carcinoma presenting as alopecia neoplastica. Indian J Dermatol Venereol Leprol 2018;84(2):188-90.
  • 3. Lause M, Kamboj A, Fernandez Faith E. Dermatologic manifestations of endocrine disorders.Transl Pediatr 2017;6(4):300-12.
  • 4. Knopp E.The scalp biopsy for hair loss and its interpretation. Semin Cutan Med Surg 2015;34(2):57-66.
  • 5. Lacarrubba F, Micali G, Tosti A. Scalp dermoscopy or trichoscopy. Curr Probl Dermatol 2015;47:21-32.
  • 6. Kil MS, Kim CW, Kim SS. Analysis of serum zinc and copper concentrations in hair loss. Ann Dermatol 2013;25(4):405-9.
  • 7. Gowda D, Premalatha W, Imtiyaz DB. Prevalence of nutritional deficiencies in hair loss among Indian participants: results of a cross-sectional study. Int J Trichology 2017;9(3):101-4.
  • 8. Deo K, Sharma YK, Wadhokar M, Tyagi N. Clinicoepidemiological observational study of acquired alopecias in females correlating with anemia and thyroid function. Dermatol Res Pract 2016;2016:6279108. doi: 10.1155/2016/6279108.
  • 9. Poonia K, Thami GP, Bhalla M, Jaiswal S, Sandhu J. Nonscarring diffuse hair loss in women: a clinico-etiological study from tertiary care center in North-West India. J Cosmet Dermatol 2018;May 17. doi: 10.1111/jocd.12559.
  • 10. Kilinc I, Alper S, Ceylan C, Ünal İ. Patent profile of alopecia areata: a retrospective study. Ege Tıp Dergisi 2002;41(1):25-7.
  • 11. Thomas E, Kadyan RS. Alopecıa areata and autoımmunıty: a clınıcal study. Indian J Dermatol. 2008;53(2):70-4.
  • 12. Ead RD. Oral zinc sulphate in alopacia areata-a double blind trial. Br J Dermatol 1981;104(4):483-4.
  • 13. Park H, Kim CW, Kim SS, Park CW. The therapeutic effect and the changed serum zinc level after zinc supplementation in alopecia areata patients who had a low serum zinc level. Ann Dermatol 2009;21(2):142-6.
  • 14. Ertugrul DT, Karadag AS, Takci Z, Bilgili SG, Ozkol HU, Tutal E, et al. Serum holotranscobalamine, vitamin B12, folic acid and homocysteine levels in alopecia areata patients. Cutan Ocul Toxicol 2013;32(1):1-3.
  • 15. Gonul M, Cakmak SK, Soylu S, Kilic A, Gul U. Serum vitamin B12, folate, ferritin, and iron levels in Turkish patients with alopecia areata. Indian J Dermatol Venereol Leprol. 2009;75(5):552.
  • 16. Lyakhovitsky A, Shemer A, Amichai B. Increased prevalence of thyroid disorders in patients with new onset alopecia areata. Australas J Dermatol 2015;56(2):103-6.
  • 17. Aksu Cerman A, Sarıkaya Solak S, Kıvanç Altunay I. Vitamin D deficiency in alopecia areata. Br J Dermatol 2014;170(6):1299-304.
  • 18. Erpolat S, Sarifakioglu E, Ayyildiz A. 25-hydroxyvitamin D status in patients with alopecia areata. Postepy Dermatol Alergol 2017;34(3):248-52.
  • 19. Gerkowicz A, Chyl-Surdacka K, Krasowska D, Chodorowska G. The role of vitamin D in non-scarring alopecia. Int J Mol Sci 2017;18(12):2653.
  • 20. Park SY, Na SY, Kim HJ, Cho S, Lee JH. Iron plays a certain role in patterned hair loss. J Korean Med Sci 2013;28(6):934-8.
  • 21. Lie C, Liew CF, Oon HH. Alopecia and the metabolic syndrome. Clin Dermatol 2018;36(1):54-61.
  • 22. Ozturk P, Kurutas E, Ataseven A, Dokur N, Gumusalan Y, Gorur A, et al. BMI and levels of zinc, copper in hair, serum and urine of Turkish male patients with androgenetic alopecia. J Trace Elem Med Biol. 2014 Jul;28(3):266-70.
  • 23. Yavuz IH, Yavuz GO, Bilgili SG, Demir H, Demir C. Assessment of Heavy Metal and Trace Element Levels in Patients with Telogen Effluvium. Indian J Dermatol 2018;63(3):246-50.
  • 24. Ayhan E, Kivrak A, Aytekin S. Biotinidase Deficiency Accompanying Hair Changes and Periorificial Lesions: A Case Report. Turk J Dermatol 2011;5:79-81
  • 25. Patel DP, Swink SM, Castelo-Soccio L. A review of the use of biotin for hair loss. Skin Appendage Disord. 2017;3(3):166-9.
  • 26. Güler Özden M, Öztaş MO, Gülekon A, Gürer MA. Kadın Olgularda Yaygın Saç Kaybı ve Eşlik Eden Bulgular. O.M.Ü. Tıp Dergisi 2008;25(2):50-6.
  • 27. Aksoy GG. Diffuse alopecia; nutritional factors and supplements. Türkderm 2014;48: Özel Sayı 1:45-7.

SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?

Year 2020, Volume: 21 Issue: 1, 24 - 29, 16.01.2020
https://doi.org/10.18229/kocatepetip.536112

Abstract

AMAÇ: Bu çalışmanın amacı saç dökülmesi şikâyetiyle başvuran hastalarda öykü ve fizik muayenenin önemini vurgulamak, hangi hastalarda laboratuvar tetkilerinin gerekli olduğunu ortaya koymaktır.

GEREÇ VE YÖNTEM: Çalışmaya Karabük Eğitim ve Araştırma Hastanesi Dermatoloji Polikliniğine Nisan 2017-Nisan 2018 tarihleri arasında saç dökülmesi şikayeti ile başvuran 622 hasta dâhil edildi. Hastane veri tabanındaki elektronik dosyalar yardımıyla herhangi bir saç dökülme türüne ait tanı alan hastaların tanı ve tedavi süreci içinde istenen tam kan sayımı, serum glukoz, vitamin B12, vitamin D, TSH, serum demir, demir bağlama kapasitesi sonuçları, eşlik eden hastalıkları kaydedildi. Bu veriler hastaların demografik özellikleriyle ve literatürle karşılaştırıldı.

BULGULAR: 622 hastanın 339’u (%55) kadın, 283’ünü (%45) erkek idi. Saç dökülmesi yakınmasıyla başvuran hastaların 321’ini (%51) yaygın saç dökülmesi, 210’unu (%33) alopesi areata, 72’sini (%12) androgenetik alopesi tanısı alan hastalar oluşturdu. Skarla sonuçlanmış saç kaybı yakınması olan hasta sayısı 14, saç dökülmesi yakınması nedeniyle başvurup tinea capitis tanısı alan hasta sayısı da 5 olarak belirlendi. Yaygın saç dökülmesi yakınmasıyla başvuran kadın hastaların %10’unda demir eksikliği anemisi, %30’unda Vitamin D eksikliği saptandı. Yaygın dökülme yakınması olan kadın hastaların %10’unda görülen demir eksikliği dışında, alopesi areata, androgenetik alopesi ve skatrisyel alopesili kadın hastalarda anormal labaratuar bulgusu saptanmadı. Saç dökülmesi ile başvuran tüm erkek hastalarda da saç dökülmesiyle ilişkilendirilebilecek anormal labaratuar bulgusu saptanmadı.

SONUÇ: Sonuç olarak saç dökülmesi şikâyeti ile başvuran bazı hastalarda laboratuar tetkikleri, saç dökülmesinin nedeni hakkında fikir vermektedir. İyi bir anamnez ve fizik muayene hangi hastada hangi testlerin istenmesi gerektiği konusunda yol gösterici olabilmektedir.


References

  • 1. Mubki T, Rudnicka L, Olszewska M, Shapiro J. Evaluation and diagnosis of the hair loss patient: part I. History and clinical examination. J Am Acad Dermatol 2014;71(3):415.e1-415.e15.
  • 2. Jose N, Isac CM, Kunjumani S, Vilasinlamma L. Sarcomatoid lung carcinoma presenting as alopecia neoplastica. Indian J Dermatol Venereol Leprol 2018;84(2):188-90.
  • 3. Lause M, Kamboj A, Fernandez Faith E. Dermatologic manifestations of endocrine disorders.Transl Pediatr 2017;6(4):300-12.
  • 4. Knopp E.The scalp biopsy for hair loss and its interpretation. Semin Cutan Med Surg 2015;34(2):57-66.
  • 5. Lacarrubba F, Micali G, Tosti A. Scalp dermoscopy or trichoscopy. Curr Probl Dermatol 2015;47:21-32.
  • 6. Kil MS, Kim CW, Kim SS. Analysis of serum zinc and copper concentrations in hair loss. Ann Dermatol 2013;25(4):405-9.
  • 7. Gowda D, Premalatha W, Imtiyaz DB. Prevalence of nutritional deficiencies in hair loss among Indian participants: results of a cross-sectional study. Int J Trichology 2017;9(3):101-4.
  • 8. Deo K, Sharma YK, Wadhokar M, Tyagi N. Clinicoepidemiological observational study of acquired alopecias in females correlating with anemia and thyroid function. Dermatol Res Pract 2016;2016:6279108. doi: 10.1155/2016/6279108.
  • 9. Poonia K, Thami GP, Bhalla M, Jaiswal S, Sandhu J. Nonscarring diffuse hair loss in women: a clinico-etiological study from tertiary care center in North-West India. J Cosmet Dermatol 2018;May 17. doi: 10.1111/jocd.12559.
  • 10. Kilinc I, Alper S, Ceylan C, Ünal İ. Patent profile of alopecia areata: a retrospective study. Ege Tıp Dergisi 2002;41(1):25-7.
  • 11. Thomas E, Kadyan RS. Alopecıa areata and autoımmunıty: a clınıcal study. Indian J Dermatol. 2008;53(2):70-4.
  • 12. Ead RD. Oral zinc sulphate in alopacia areata-a double blind trial. Br J Dermatol 1981;104(4):483-4.
  • 13. Park H, Kim CW, Kim SS, Park CW. The therapeutic effect and the changed serum zinc level after zinc supplementation in alopecia areata patients who had a low serum zinc level. Ann Dermatol 2009;21(2):142-6.
  • 14. Ertugrul DT, Karadag AS, Takci Z, Bilgili SG, Ozkol HU, Tutal E, et al. Serum holotranscobalamine, vitamin B12, folic acid and homocysteine levels in alopecia areata patients. Cutan Ocul Toxicol 2013;32(1):1-3.
  • 15. Gonul M, Cakmak SK, Soylu S, Kilic A, Gul U. Serum vitamin B12, folate, ferritin, and iron levels in Turkish patients with alopecia areata. Indian J Dermatol Venereol Leprol. 2009;75(5):552.
  • 16. Lyakhovitsky A, Shemer A, Amichai B. Increased prevalence of thyroid disorders in patients with new onset alopecia areata. Australas J Dermatol 2015;56(2):103-6.
  • 17. Aksu Cerman A, Sarıkaya Solak S, Kıvanç Altunay I. Vitamin D deficiency in alopecia areata. Br J Dermatol 2014;170(6):1299-304.
  • 18. Erpolat S, Sarifakioglu E, Ayyildiz A. 25-hydroxyvitamin D status in patients with alopecia areata. Postepy Dermatol Alergol 2017;34(3):248-52.
  • 19. Gerkowicz A, Chyl-Surdacka K, Krasowska D, Chodorowska G. The role of vitamin D in non-scarring alopecia. Int J Mol Sci 2017;18(12):2653.
  • 20. Park SY, Na SY, Kim HJ, Cho S, Lee JH. Iron plays a certain role in patterned hair loss. J Korean Med Sci 2013;28(6):934-8.
  • 21. Lie C, Liew CF, Oon HH. Alopecia and the metabolic syndrome. Clin Dermatol 2018;36(1):54-61.
  • 22. Ozturk P, Kurutas E, Ataseven A, Dokur N, Gumusalan Y, Gorur A, et al. BMI and levels of zinc, copper in hair, serum and urine of Turkish male patients with androgenetic alopecia. J Trace Elem Med Biol. 2014 Jul;28(3):266-70.
  • 23. Yavuz IH, Yavuz GO, Bilgili SG, Demir H, Demir C. Assessment of Heavy Metal and Trace Element Levels in Patients with Telogen Effluvium. Indian J Dermatol 2018;63(3):246-50.
  • 24. Ayhan E, Kivrak A, Aytekin S. Biotinidase Deficiency Accompanying Hair Changes and Periorificial Lesions: A Case Report. Turk J Dermatol 2011;5:79-81
  • 25. Patel DP, Swink SM, Castelo-Soccio L. A review of the use of biotin for hair loss. Skin Appendage Disord. 2017;3(3):166-9.
  • 26. Güler Özden M, Öztaş MO, Gülekon A, Gürer MA. Kadın Olgularda Yaygın Saç Kaybı ve Eşlik Eden Bulgular. O.M.Ü. Tıp Dergisi 2008;25(2):50-6.
  • 27. Aksoy GG. Diffuse alopecia; nutritional factors and supplements. Türkderm 2014;48: Özel Sayı 1:45-7.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Articles
Authors

Habibullah Aktaş 0000-0001-9239-1659

Gökşen Ertuğrul 0000-0002-5167-4780

Publication Date January 16, 2020
Acceptance Date May 27, 2019
Published in Issue Year 2020 Volume: 21 Issue: 1

Cite

APA Aktaş, H., & Ertuğrul, G. (2020). SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?. Kocatepe Tıp Dergisi, 21(1), 24-29. https://doi.org/10.18229/kocatepetip.536112
AMA Aktaş H, Ertuğrul G. SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?. KTD. January 2020;21(1):24-29. doi:10.18229/kocatepetip.536112
Chicago Aktaş, Habibullah, and Gökşen Ertuğrul. “SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?”. Kocatepe Tıp Dergisi 21, no. 1 (January 2020): 24-29. https://doi.org/10.18229/kocatepetip.536112.
EndNote Aktaş H, Ertuğrul G (January 1, 2020) SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?. Kocatepe Tıp Dergisi 21 1 24–29.
IEEE H. Aktaş and G. Ertuğrul, “SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?”, KTD, vol. 21, no. 1, pp. 24–29, 2020, doi: 10.18229/kocatepetip.536112.
ISNAD Aktaş, Habibullah - Ertuğrul, Gökşen. “SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?”. Kocatepe Tıp Dergisi 21/1 (January 2020), 24-29. https://doi.org/10.18229/kocatepetip.536112.
JAMA Aktaş H, Ertuğrul G. SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?. KTD. 2020;21:24–29.
MLA Aktaş, Habibullah and Gökşen Ertuğrul. “SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?”. Kocatepe Tıp Dergisi, vol. 21, no. 1, 2020, pp. 24-29, doi:10.18229/kocatepetip.536112.
Vancouver Aktaş H, Ertuğrul G. SAÇ DÖKÜLMESİ: LABORATUAR İNCELEMELERİ KİME GEREKLİ?. KTD. 2020;21(1):24-9.

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