Kadın Olgularda Yaygın Saç Kaybı ve Eşlik Eden Bulgular

Abstract

Yaygın saç kaybı, birçok hormonal, besinsel faktöre, çeşitli kimyasal maddelere, ilaçlara, sistemik/kutanöz hastalıklara ve emosyonel strese bağlı olarak ortaya çıkabilir. Bu birlikteliklerden bazıları oldukça iyi tanımlanmışsa da bazıları çoğu kez suçlanmakla birlikte daha az tanımlanabilmişlerdir. Bu çalışmanın amacı, altta yatan nedenler belirlenip, dışlandığında oldukça iyi bir prognoza sahip olan yaygın saç kaybı hastalarında saptanan sistemik bulguların ve eşlik eden hastalıkların incelenmesidir. Ocak 2000-Nisan 2007 tarihleri arasında, Gazi ve Yeditepe Üniversitesi Hastanesi Dermatoloji kliniklerine yaygın saç kaybı yakınması ile başvuran, dermatolojik muayene ve sorgulama sonucunda alopesi areata veya androgenetik alopesi düşünülmeyen 100 kadın olgu ilişkili olabileceği düşünülen hastalıklar ve bulgular açısından geriye dönük olarak incelendi. Hastalarda, bakır (n=100), çinko (n=100), ferritin (n=100), serum demiri (n= 68), tam kan sayımı (n=100), serbest T3 (n=100), serbest T4 (n=100), tiroid uyarıcı hormon (TSH) (n=100), eritrosit sedimentasyon hızı (n=64), vitamin B12 (n=100) ve folik asit (n=100) yapılan biyokimyasal ve hematolojik incelemelerdi. Yapılan biyokimyasal ve hematolojik incelemeler sonucunda dikkati çeken bulgular; olguların %4’ünde bakır, %9’unda çinko, %36’sında ferritin ve %22’sinde demir eksikliğine rastlanması oldu. %10 oranında saptanan aneminin sebebi olarak da demir eksikliği dışında patoloji saptanmadı. Hastaların 5’inde helikobakter pilori (+) gastrit, 15’inde çeşitli psikiyatrik bozukluklar, 18’inde ise tiroit fonksiyon bozuklukları ve ötiroid guatr klinik tabloya eşlik etmekteydi. Bu çalışmada yaygın saç kaybında saptadığımız laboratuar bulguları ve eşlik eden hastalıklar incelenerek konuyla ilgili literatür tartışılmıştır. Çalışmamızda, serum bakır, çinko ve tiroit fonksiyon bozukluğu düşük bir oranda saptanmıştır. Bu sonuç, bu tetkiklerin rutin olarak istenmemesi konusunda bizleri uyarmaktadır. Bu tetkiklerin, ancak klinik olarak bir şüphe veya uygulanan tedavilere direnç olduğunda istenmesinde yarar vardır. Bunun yanı sıra, ferritin düzeyi ve tam kan sayımının bu hasta nüfusunda istenmesinde fayda olduğu sonucuna varılmıştır. Diffuse Hair Loss in Females and Associating Findings Diffuse hair loss depends on many chemicals, drugs, systemic/cutaneous diseases, emotional stres and hormonal/nutritional factors. Although a part of these associations has been demonstrated in detail, many suspected factors need to be investigated. The aim of this study is to investigate the laboratory findings and associating diseases in diffuse hair loss patients, which have a good prognosis when the underlying factors can be detected and eliminated. One hundred female diffuse hair loss patients were investigated in the view of related diseases and findings retrospectively, between January 2000- April 2007 in Gazi and Yeditepe University Hospital Dermatology clinics. Copper (n=100), zinc (n=100), ferritine (n=100), serum iron (n= 68), total blood count (n=100), free T3 (n=100), free T4 (n=100), thyroid stimulating hormone (TSH) (n=100), erhytrosyte sedimentation rate (n= 64), vitamine B12 (n=100) and folic acide (n=100) were the biochemical and haematologic investigations tested in the patient population. 4% copper, 29% zinc, 36% ferritine and 22% iron deficiency were detected with biochemical and hematological investigations. In the anemic patients- which are constituting the 10% of patients- the only etiological factor was iron deficiency. 5 patients had associating helicobacter pylori (+) gastritis, 15 patients had psychiatric disorders, 18 patients had thyroid function disorders and euthyroid guatr. We have evaluated the laboratory results and associating diseases in our study and discussed the literature related with these results. We detected copper, zinc and thyroid function defects in a low rate, in this study. This result warns us about not to ask for these laboratory tests routinly. We should ask these laboratory tests when there is a clinical suspicion or resistance to treatments. In addition, its been concluded that investigating serum ferritine level and total blood count is usefull in this patient population.

Keywords

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