Acquired Alopecias in Females Correlating With Anemia and Thyroid Function

8/16/2019 Acquired Alopecias in Females Correlating With Anemia and Thyroid Function

1/6

Research ArticleClinicoepidemiological Observational Study of

Acquired Alopecias in Females Correlating with Anemia andThyroid Function

Kirti Deo, Yugal K. Sharma, Meenakshi Wadhokar, and Neha Tyagi

Department of Dermatology, Dr. D. Y. Patil Medical College and Hospital and Research Centre, Pimpri, Pune, Maharashtra , India

Correspondence should be addressed to Meenakshi Wadhokar; [email protected]

Received November ; Revised January ; Accepted January

Academic Editor: Elizabeth Helen Kemp

Copyright © Kirti Deo et al. Tis is an openaccess article distributed under the Creative Commons AttributionLicense, whichpermits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Alopecia can either be inherited or acquired; the latter, more common, can be diffuse, patterned, and ocal, each having cicatricialand noncicatricial orms. Tis observational study o cases in a semiurban Indian population aimed to detect the prevalence o various orms o acquired alopecia in emales and correlate the same with levels o hemoglobin, serum erritin, triiodothyronine,thyroxin, and thyroid stimulating hormone. Te majority (, .%) o our cases o alopecia had telogen effluvium ollowedby emale pattern alopecia (, .%). Stress (, .%), topical application o chemicals (, .%), systemic medications or

concurrent illnesses (,%), and pregnancy (,.%) were the common exacerbating actors.Neither low hemoglobin (


2/6

Dermatology Research and Practice

: Distribution o alopecia in the age groups.

Age in years elogen

effluviumAlopecia

areataFemale pattern

hair lossFrontal brosing

alopeciaAnagen

effluvium otal

–

–

–

– –

otal

: Location o alopecia.

Location elogen

effluviumAlopecia

areataFemale pattern

hair lossFrontal brosing

alopeciaAnagen

effluvium otal

Diffuse

Parietal

emporal

Vertex

Occipital

otal

As excessive intake o nutritional supplements may actually lead to increased hair loss, it appears logical to prescribethemin cases only with the proven deciency [].

Tisstudy aimed to detect the prevalence o various ormso acquired alopecia in emales and their correlation withanemia and triiodothyronine(), thyroxin (), and thyroidstimulating hormone (SH) levels.

2. Materials and Methods

Tis observational study comprised consecutive emalepatients presenting to our department or the treatment o alopecia during the period o October to July .Institutional ethical committee clearance and an inormedconsent o each patient were obtained and detailed history and examination undertaken to assess the type o alope-cia, exacerbating actors, and associated systemic illnesses.Patients with diffuse hair loss, presence o one or more o theexacerbating actors, namely, stress, pregnancy, and applica-tion o chemicals, and positive hair pull test were consideredto have telogen effluvium. Patients with reduction o numbero hair, especially in biparietal, bitemporal, andvertex regionswith preservation o anterior hair implantation line, wereconsidered to have emale pattern hair loss. However, over-lapping o both o these diseases could occur in some cases.All patients were tested or hemoglobin (Hb), serum erritin,and , , and SH levels. Te data obtained were analyzedstatistically using SPSS version .. Correlation between

variables was calculated using Spearman’s rank correlationcoefficient and Chi-square test. A value o < 0.05 wasconsidered signicant.

3. Results

Te age o our study patients ranged rom to (mean:. ± .) years, with the majority (, .%) belong-ing to the third decade (able ). Afer onset o alopecia

patients took one to (mean: . ± .) months toseek consultation, the largest segment (, .%) reportingafer months resulting in a signicant, but mild positive,correlation (rho = .; = 0.011); OPD consultation getsincreasingly delayed with the advancing age o the patients.

Te rst and second common types o alopecia in ourstudywere telogen effluvium (E) (, .%) andemale pat-tern hair loss (FPHL) (, .%) (able ). Te exacerbatingactors ound across the spectrum o alopecia were stress, in (.%) patients; application o chemicals such as mehndi

or dye, in (.%); pregnancy and/or delivery six monthspreceding the presentation, in (.%). Sixty-two (.%)patients were undergoing treatment or associated systemicillness(es): (.%) or diabetes mellitus; (.%) orpolycystic ovarian disease; (.%) or hypertension; (.%) or hypothyroidism; (.%) or hyperthyroidism;and (.%) or tuberculosis and cancer each. Dandruff seenin (.%)and oily scalp in (.%) were notstatistically signicantly associated. Te majority (, .%) o patientshad diffuse hair loss ollowed by hair loss over the vertex (,.%) (able ). Family history o alopecia was given by only (.%). FPHL, ound in (%) postmenopausal cases inour study, revealed a statistically signicant association ( =

0.006, strength o association, 2

= 21.36). Characteristic nailpitting seen in (.%) o cases o alopecia areata was alsoassociated signicantly ( = 0.001, strength o association,

2 = 0.545).

Hemoglobin levels ranged rom . to . (mean:. ± .) gm%; anemia (Hb < gm%) was present in (.%). Serum erritin levels ranged rom . to .(mean: . ± .) g/L. Iron deciency was seen in (.%) o our study population having serum erritin < g/L; neither hemoglobin nor serum erritin levels werestatistically signicant. Tyroid disorders present in (%)patients, including nine (.%) newly diagnosed ones, too,were not o statistical signicance (able ).


3/6


4/6


the well-known role o psychological stress in precipitatingAA [, ]. However, amily history o AA in our study wasrarely positive (, .%), as also remarked in previous studies:% (Sharma et al.) [] and .% (an et al.) [].

Anagen effluvium and rontal brosing alopecia eachoccurred only in one case in our study.

Hemoglobin levels ranged rom . to . (mean: .± .) gm% in our study. Ninety-nine (.%) patients wereound to be anemic (Hb < gm%); (.%) were mild(Hb –. gm%), (%) moderate (Hb –. gm%),and none severe (Hb


5/6


[] A. M. Finner, “Alopecia areata: clinical presentation, diagnosis,and unusual cases,” Dermatologic Terapy , vol. , no. , pp.–, .

[] K. P. Kyriakis, K. Paltazidou, E. Kosma, E. Soouri, A. adros,and E. Rachioli, “Alopecia areata preelnce by gender and age,” Journal of the European Academy of Dermatology and Venereol-ogy , vol. , no. , pp. –, .

[] D. Wasserman, D. A. Guzman-Sanchez, K. Scott, and A.Mcmichael, “Alopecia areata,” International Journal of Derma-tology , vol. , no. , pp. –, .

[] S.-Y. Chu, Y.-J.Chen, W.-C. senget al., “Psychiatriccomorbidi-ties in patients with alopecia areata in aiwan: a case-controlstudy,” British Journal of Dermatology , vol. , no. , pp. –, .

[] L. Manolache and V. Benea, “Stress in patients with alopeciaareata and vitiligo,” Journal of the European Academy of Derma-tology and Venereology , vol. , no. , pp. –, .

[] P. Sharma, A. Fernandes, A. Bharatiet al., “Psychological aspectso Alopecia Areata,” Indian Journal of Mental Health, vol. , no., .

[] A..Güleç, N. anriverdi, Ç. Dürü, Y. Saray, and C. Akçali, “Terole o psychological actors in alopecia areata and the impacto the disease on the quality o lie,” International Journal of Dermatology , vol. , no. , pp. –, .

[] V. K. Sharma, G. Dawn,and B. Kumar, “Proleo alopecia areatain Northern India,” International Journal of Dermatology , vol., no. , pp. –, .

[] E. an, Y.-K. ay, C.-L. Goh, and Y. C. Giam, “Te pattern andprole o alopecia areata in Singapore—a study o Asians,”InternationalJournalof Dermatology , vol. ,no. ,pp. –,.

[] International Institute or Population Sciences (IIPS) andMacro International, “National amily health survey (NFHS-),”ech. Rep. -, IIPS, Mumbai, India, .

[] M. E. Bentley and P. L. Griffiths, “Te burden o anemia amongwomen in India,” European Journal of Clinical Nutrition, vol. ,no. , pp. –, .

[] M. M. Karim, M. A. Wahab, L. Khondoker, and M. S. Khan,“Low iron level is related to telogen effluvium in women,” Bang-ladesh Journal of Medicine, vol. , no. , pp. –, .

[] R. Sinclair, “Tere is no clear association between low serumerritin and chronic diffuse telogen hair loss,” British Journal of Dermatology , vol. , no. , pp. –, .

[] G. Lutz, “Hair loss and hyperprolactinemia in women,” Der-mato-Endocrinology , vol. , no. , pp. –, .


6/6

Submit your manuscripts at

http://www.hindawi.com

Acquired Alopecias in Females Correlating With Anemia and Thyroid Function

Documents

Transcript of Acquired Alopecias in Females Correlating With Anemia and Thyroid Function