Serum vitamin levels correlate with treatment efficacy in hair loss management.
the verdict
INSUFFICIENT LEANING
refutedsupported
the weight of evidence
3 sources for · 0 against
Available studies provide partial support, indicating that serum iron and ferritin levels correlate with certain types of hair loss and influence treatment response in specific therapies, but they do not establish a general correlation across all serum vitamin levels and hair loss management efficacy.
Background Alopecia can be inherited or acquired, cicatricial or non-cicatricial. Sometimes the diagnosis can pose difficulties, and in such cases, dermoscopy can aid in the diagnosis. The treatment can also be difficult due to its multiple etiologies. Iron deficiency is an important cause of alopecia but its relationship with alopecia remains controversial.
Methods This was a hospital based, cross sectional observational study with 70 female patients. After taking consent, dermoscopic evaluation of the scalp was done and photographs were taken. Serum ferritin levels were done for all the subjects. Software (SPSS version 16.0 statistical package) was used throughout. Mean and standard deviation were used for continuous variables.
Results Most common cause of alopecia was telogen effluvium. Most common dermoscopic finding was thin hair. In our study, we found a correlation between serum ferritin levels and certain patterns of alopecia like telogen effluvium, female pattern hair loss (FPHL), alopecia areata.
Conclusion Dermoscopy of the scalp can aid in the diagnosis of difficult conditions. Serum ferritin and haemoglobin levels are reduced in certain types of alopecia like telogen effluvium, FPHL and alopecia areata.
Journal of Pakistan Association of Dermatologists. 2019; 29(3): 322-327.
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Address for correspondence
Dr. Dr. Vinma Shetty, Associate Professor,
Department of Dermatology, Venereology and
Leprosy,
A.J Institute of Medical Sciences, Mangalore,
Karnataka, India
Email: vinma_shetty@yahoo.co.in
Original Article
Dermoscopic study of hair loss in females and its
correlation with serum ferritin levels
Introduction
Alopecia can result in loss of self -esteem and
lack of self-confidence1,2 and is often difficult to
treat.3 Some relationship has been documented
between iron deficiency and hair loss, however
it is yet to be confirmed.3
Dermoscopy is a non-invasive technique used to
visualise pigmented skin lesions.4 “Trichoscopy”
is the term used for dermoscopy of hair and th e
scalp.5 Trichoscopy is used to distinguish the
different types of alopecia and identify
diagnostic signs.6
In this study, we examined the dermoscopic
pattern of different types of hair loss in females
and its correlation with serum ferritin levels.
Materials and Methods
This was a hospital based, cross sectional
observational study. Female subjects in the age
group of 15 -55 years with complaints of
alopecia attending the Dermatology OPD from
April 2018 to August 2018, were studied after
obtaining ethical clearance from the Institutional
Ethics Committee. A convenient sample size of
70 was adopted. For this study, we defined
Vinma Shetty, Hafsa Eram, Saumya Goel, Amita Murali Babu
Department of Dermatology, Venereology and Leprosy, A.J . Institute of Medical Sciences,
Mangalore, Karnataka, India.
Abstract Background Alopecia can be inherited or acquired, cicatricial or non -cicatricial. Sometimes the
diagnosis can pose difficulties, and in such cases, dermoscopy can aid in the diagnosis. The
treatment can also be difficult due to its multiple etiologies. Iron deficiency is an important cause of
alopecia but its relationship with alopecia remains controversial.
Methods This was a hospital based, cross sectional o bservational study with 70 female patients.
After taking consent, dermoscopic evaluation of the scalp was done and photographs were taken.
Serum ferritin levels were done for all the subjects. Software (SPSS version 16.0 statistical
package) was used throughout. Mean and standard deviation were used for continuous variables.
Results Most common cause of alopecia was telogen effluvium. Most common dermoscopic
finding was thin hair. In our study, we found a correlation between serum ferritin levels and certa in
patterns of alopecia like telogen effluvium, female pattern hair loss (FPHL), alopecia areata.
Conclusion Dermoscopy of the scalp can aid in the diagnosis of difficult conditions. Serum ferritin
and haemoglobin levels are reduced in certain types of al opecia like telogen effluvium, FPHL and
alopecia areata.
Key words
Dermoscopy, alopecia, serum ferritin.
Journal of Pakistan Association of Dermatologists. 2019; 29(3): 322-327.
324
Figure 1 Patterns of alopecia among study subjects
Table 3 Prominent dermoscopic features in different patterns of alopecia
Type of alopecia Dermoscopic findings
Telogen effluvium Thin hair (81.8%), yellow dots (54.5%), peripilar erythema (18.2%)
Alopecia areata Yellow dots (70%), black dots (60%), thin hair (40%), exclamation mark hair (30%)
FPHL Diameter diversity >20% (66.7%), thin hair (66.7%), yellow dots (55.6%)
DLE Loss of follicles (100%), Honeycomb pigment network (50%)
FPHL: Female pattern hair loss; DLE: Discoid lupus erythematosus
Table 4 Correlation of pattern of hair loss with serum ferritin and haemoglobin levels
Investigation Telogen effluvium FPHL Alopecia areata
Serum ferritin (µg/L) Mean ± SD 19.3 ± 4.7 32.8 ± 19.6 22.7 ± 5.6
Hb (g/dL) Mean ± SD 10.7 ± 1.2 11.2 ± 1.4 11.5 ± 1.2
Hb: Haemoglobin; FPHL: Female pattern hair loss
The most common finding in telogen effluvium
was thin hair (81.8%) followed by yellow dots
(54.5%). In alopecia areata , yellow dots (70%)
was the most common finding, followed by
black dots (60%) and thin hair (40%),
exclamation mark hair was found in 30% of the
subjects. Diameter density >20% and thin hair
(66.7%) was the most common finding in FPHL,
followed by yellow dots (55.6%) (Table 3).
The serum ferritin (19.3±4.7) and haemoglobin
(10.7±1.2) were lowest in subjects with telogen
effluvium, followed by alopecia areata (Serum
ferritin=22.7±5.6, haemoglobin = 11.5±1.2) and
FPHL (serum ferritin = 32.8±19.6, haemoglobin
Journal of Pakistan Association of Dermatologists. 2019; 29(3): 322-327.
327
telogen effluvium who received oral iron
therapy. However, Olsen et al .17 reported no
difference in
<h4>Background</h4>Alopecia areata (AA) is an autoimmune disorder and the second most common form of non-scarring hair loss, affecting approximately 1.7-2% of the global population. Although it predominantly presents before the age of 40, AA can occur at any age and is strongly associated with genetic predisposition. Environmental, hormonal, and psychological factors have been implicated in disease onset and progression. Recent evidence highlights the immunomodulatory role of vitamin D, traditionally recognized for its functions in bone metabolism and calcium homeostasis, in skin health and immune regulation, raising interest in its potential relevance to AA pathogenesis and treatment.<h4>Summary</h4>This review examines the epidemiology, genetic predisposition, and immunological mechanisms underlying AA, emphasizing the loss of immune privilege in hair follicles as a key pathogenic event. Additionally, it examines the role of vitamin D and its receptor (VDR) in hair follicle homeostasis, discussing the association between vitamin D deficiency, altered VDR expression, and disease severity. Emerging clinical data suggest that vitamin D supplementation and analogs, such as calcipotriol, may serve as adjunctive therapeutic strategies, with potential benefits in mitigating disease severity and reducing relapse rates.<h4>Key messages</h4>(1) Vitamin D serves as a critical immunomodulator in AA, regulating follicular immune privilege and key inflammatory pathways involved in disease pathogenesis. (2) Vitamin D deficiency is frequently observed in patients with AA and has been associated with increased disease severity, prolonged duration, and a higher risk of relapse. (3) Emerging evidence supports the therapeutic potential of vitamin D analogs and supplementation in AA, positioning vitamin D as a promising adjunct or primary treatment modality.
Biochemical investigations were performed before treatment and after 3, 6, and 12 months. In the treated group, a significant (P less than 0.01) mean increase in total hair density (hair/cm2) and meaningful hair density (non-vellus hair/cm2) was found in patients in whom the serum ferritin was above, but not below 40 micrograms/l. However, in the control group a significant (P less than 0.05) mean decrease in total hair density and meaningful hair density was observed after 12 months. No correlation between serum ferritin levels and the degree of hair loss within this group could be established. Patients treated with the anti-androgen cyproterone acetate and ethinyl oestradiol respond best when serum ferritin is above 40 micrograms/l. Published in Clinical endocrinology (1992)
Everything we examined (3)
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