Nonscarring scalp alopecia: Which laboratory analysis should we perform on whom?

Ümran Öner, Necmettin Akdeniz

Other Turkish journal of medical sciences 2022 8 citations

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Study Design

Type d'étude: retrospective cross-sectional study
Taille de l'échantillon: 467

Intervention: Nonscarring scalp alopecia: Which laboratory analysis should we perform on whom? not applicable
Comparateur: Placebo
Direction de l'effet: Mixed
Risque de biais: Moderate

Abstract

BACKGROUND: Vitamins and minerals are thought to play an essential but not entirely clear role in developing, preventing, and treating nonscarring alopecia. Telogen effluvium, androgenetic alopecia, and alopecia areata are the most common forms of nonscarring alopecias. We would like to present a different perspective on laboratory abnormalities in patients with nonscarring alopecia. METHODS: A total of 467 patients (287 females, 180 males) were included retrospectively: One hundred and sixty patients in the telogen effluvium group, 101 patients in the androgenetic alopecia group, 99 patients in the alopecia areata group, and 107 patients in the hair loss group (patients who could not be diagnosed with any nonscarring alopecia and wanted to have an analysis due to the complaint of hair loss). Sociodemographic data, diagnostic distribution, and laboratory findings (hemoglobin, ferritin, vitamin B12, vitamin D, and TSH) were evaluated and compared. RESULTS: The most common diagnosis was telogen effluvium in females and androgenetic alopecia in males. In women, hemoglobin (12.2% vs. 1.1%) and ferritin deficiencies (22.3% vs. 8.9%) were significantly higher than in men (p < 0.001, p < 0.001) Ferritin, hemoglobin, and vitamin B12 levels were significantly lower, and the number of patients with vitamin D, ferritin, hemoglobin and vitamin B12 deficiencies were significantly higher in the telogen effluvium group compared to the other groups. Laboratory abnormalities were detected least in the hair loss group.

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Figures

Figure

Diagnostic algorithm or laboratory analysis flowchart for evaluating nonscarring scalp alopecia, guiding clinicians on which tests to perform based on clinical presentation.

flowchart

Tables

Table 1

	Age (years)	Age range (years)	Female		Male		Total
	M ± SD		n	%	n	%	n
TE	27.7 ± 8.8a	7–55	156	97.5a	4	2.5	160
AGA	25.6 ± 7.3a	15–50	25	24.8b	76	75.2	101
AA	26.1 ± 12.3a	2–58	25	25.3b	74	74.7	99
HL	21.4 ± 9.2b	2–55	81	75.7c	26	24.3	107
Total	25.5 ± 9.7	2–58	287	61.4	180	38.6	467
p	<0.001 *		<0.001 **

Table 2

	Vitamin D deficiency		Hemoglobin deficiency		Ferritin deficiency		Vitamin B₁₂ deficiency		Thyroid dysfunction
	n	%	n	%	n	%	n	%	n	%
Female	215	74.9	35	12.2	64	22.3	33	11.5	22	7.7
Male	130	72.2	2	1.1	16	8.9	21	11.7	10	5.6
p *	0.519		<0.001		<0.001		0.956		0.380

Table 3

	Vitamin D (ng/mL)	Hemoglobin (g/dL)	Ferritin (ng/mL)	Vitamin B₁₂ (pg/mL)	TSH (UI/mL)
	M ± SD	M ± SD	M ± SD	M ± SD	M ± SD
TE	14.6 ± 11.1	13.5 ± 1.6 a	28.3 ± 37.4 a	317.7 ± 134.4 a	2.2 ± 1.6
AGA	16.2 ± 8.4	16.1 ± 1.4b	100.0 ± 84.7b	316.8 ± 170.5 a	2.1 ± 1.4
AA	15.7 ± 9.6	15.4 ± 1.5c	93.5 ± 103.9b	344.6 ± 150.4a,b	2.3 ± 2.0
HL	17.9 ± 11.3	14.8 ± 1.4d	59.3 ± 47.6c	377.1 ± 154.9b	2.2 ± 1.1
p *	0.086	<0.001	<0.001	0.007	0.943

Table 4

	Vitamin D deficiency		Hemoglobin deficiency		Ferritin deficiency		Vitamin B₁₂ deficiency		Thyroid dysfunction
	n	%	n	%	n	%	n	%	n	%
TE	127	79.4 a	32	20.0 a	53	33.1 a	32	20.0 a	15	9.4
AGA	79	78.2 a,b	0	0.0b	8	7.9b	11	10.9a,b	6	5.9
AA	70	70.7 a,b	4	4.0b	13	13.1b	8	8.1a,b	8	8.1
HL	69	64.5b	1	0.9b	6 b	5.6b	3	2.8b	3	2.8
p *	0.031		<0.001		<0.001		<0.001		0.194

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