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Retrospective Review of 2851 Female Patients With Telogen Effluvium: A Single-Center Experience.

Ömer Karakoyun, Erhan Ayhan, İsmail Yıldız
Other Journal of cosmetic dermatology 2025 4 citazioni
PubMed DOI CC-BY PDF
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Study Design

Tipo di studio
Retrospective cohort
Dimensione del campione
2851
Intervento
Retrospective Review of 2851 Female Patients With Telogen Effluvium: A Single-Center Experience. None
Comparatore
Placebo
Direzione dell'effetto
Neutral
Rischio di bias
Moderate

Abstract

OBJECTIVE: Telogen effluvium, the most common cause of diffuse and non-scarring alopecia in women, is frequently diagnosed in dermatology outpatient clinics and can be caused by various etiological factors such as medications, trauma, emotional, and physiological stress. In patients presenting with complaints of telogen effluvium, we aimed to investigate abnormal levels of serum ferritin, vitamin B12, folic acid, thyroid function tests, and hemoglobin and determine which of these abnormal values might be significantly associated with telogen effluvium. MATERIAL AND METHODS: In this study, 2851 female patients diagnosed with telogen effluvium who applied to the Dicle University Dermatology outpatient clinic between January 1, 2010 and June 30, 2024 were retrospectively evaluated. The relationship between these laboratory abnormalities and telogen effluvium, as well as their significance in different age groups, was analyzed using the SPSS-27.0 program. Associations were analyzed using Kolmogorov-Smirnov test, dependent t-test, Wilcoxon test, Pearson chi-square (χ2) test, Yates chi-square (χ2) test, Fisher chi-square (χ2) test analysis, Mc-Nemar test, Pearson/spearman correlation analysis, and logistic regression analysis. A p value of < 0.05 was considered statistically significant. RESULTS: The mean age of 2851 female patients included in our study was 26.33 years, 12.8% (n = 366) were under 18 years of age, 83.5% (n = 2380) were between 18 and 45 years of age, and 3.7% (n = 105) were over 45 years of age. Hemoglobin values were determined in 2496 of 2851 patients and values below the reference range were found in 317 patients (11.1%). Ferritin was found to be low in 1123 (46.5%) of 2413 patients. Vitamin 12 deficiency was detected in 150 (5.8%), folic acid deficiency in 8 (0.6%), and iron deficiency in 685 (29.5%) patients. As can be seen in our study, deficiency of laboratory parameters, especially ferritin and serum iron, is a common finding in female patients presenting with TE. CONCLUSION: This study showed that biochemical tests, complete blood counts, and hormonal tests are important tools in investigating the etiology and guiding the treatment in patients diagnosed with telogen effluvium, as various etiological factors may be present. Furthermore, it was determined that parameters such as vitamin B12, ferritin, TSH, and T3 hold varying levels of importance during significant phases of women's physiological development, such as adolescence and post-menopausal periods.

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Tables

TABLE 1

Percentage of laboratory parameters in 2851 patients (%)Number of patients tested (n)Reference rangeMean valueBelow reference (n/%)Above reference (n/%)
Hb (87.55%)249612–16 g/dL13.40317 (11.1%)121 (4.8%)
Ferritin (84.64%)241318–370 ng/dL29.691123 (46.5%)0 (0%)
Iron (81.41%)232160–180 μg/dL241.31685 (29.5%)541 (23.3%)
Vitamin B12 (90.74%)2587160–900 pg/mL376.72150 (5.8%)74 (2.9%)
Folic acid (50.16%)14303.0–17 ng/mL8.628 (0.6%)40 (2.8%)
TSH (91.41%)26060.35–4.94 mIU/L1.9829 (1%.1)63 (2.4%)
T3 (35.99%)10262.5–5 ng/dL4.4513 (1%.3)314 (30.6%)

TABLE 2

ParametersReference rangesUnder 18 years old18–45 years oldOver 45 years p

Hb

n = 2496

< 12 g/dL n = 36 (11.07%) n = 263 (12.63%) n = 18 (20.2)0.2268
12–16 g/dL n = 275 (84.61%) n = 1716 (82.42%) n = 67 (75.2%)
> 16 g/dL n = 14 (4.30%) n = 103 (4.94%) n = 4 (4494%)

Ferritin

n = 2413

< 18 ng/dL n = 127 (40.18%) n = 961 (47.64%) n = 35 (43.7%)0.0415
18–370 ng/dL n = 189 (59.81%) n = 1056 (52.35%) n = 45 (56.25%)
> 370 ng/dL n = 0 (0%) n = 0 (0%) n = 0 (0%)

Iron

n = 2321

< 60 μg/dL n = 84 (27.36%) n = 573 (29.73%) n = 28 (32.18%)0.2906
60–180 μg/dL n = 143 (46.57%) n = 906 (47.01%) n = 46 (52.87%)
> 180 μg/dL n = 80 (26.05%) n = 448 (23.24%) n = 13 (14.9%)

Vitamin B12

n = 2587

< 160 pg/mL n = 14 (4.19%) n = 131 (6.07%) n = 5 (5.10%)0.0315
160–900 pg/mL n = 302 (90.41%) n = 1971 (91.46%) n = 90 (91.83%)
> 900 pg/mL n = 18 (5.38%) n = 53 (2459%) n = 3 (3.06%)

Folic acid

n = 1430

< 3.0 ng/mL n = 0 (0%) n = 7 (0.58%) n = 1 (1.58%)0.6035
3.0–17 ng/mL n = 174 (96.6%) n = 1147 (96.6%) n = 61 (96.82%)
> 17 ng/mL n = 6 (3.3%) n = 33 (2.78%) n = 1 (1.58%)

TSH

n = 2606

< 0.35 mIU/L n = 1 (0.30%) n = 25 (1.14%) n = 3 (3.15%)0.1015
0.35–4.94 mIU/L  n = 317 (96.64%) n = 2109 (96.6%) n = 88 (92.6%)
> 4.94 mIU/L n = 10 (3.0%) n = 49 (2.24%) n = 4 (4.21%)

T3

n = 1026

< 2.5 ng/dL n = 0 (0%) n = 13 (1.51%) n = 0 (0%)< 0.001
2.5–5 ng/dL n = 62 (49.2%) n = 605 (70.43%) n = 32 (78.04%)
> 5 ng/dL n = 64 (50.79%) n = 241 (28.0%) n = 9 (21.9%)

References

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  2. Telogen Effluvium. New Concepts and Review Archives of Dermatology, 1993
  3. Chronic Telogen Effluvium Is due to a Reduction in the Variance of Anagen Duration Australian Journal of Dermatology, 2010
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  5. Clinical Approach to the Patient With Alopecia Seminars in Cutaneous Medicine and Surgery, 2006
  6. Telogen Effluvium in Daily Practice: Patient Characteristics, Laboratory Parameters, and Treatment Modalities of 3028 Patients With Telogen Effluvium Journal of Cosmetic Dermatology, 2021
  7. Vitamin and Mineral Deficiencies in Patients With Telogen Effluvium: A Retrospective Cross‐Sectional Study Journal of Drugs in Dermatology, 2016
  8. Retrospective Evaluation of Laboratory Data of Patients With Telogen Effluvium Annals of Medical Research, 2019
  9. The Role of Vitamins and Minerals in Hair Loss: A Review Dermatologic Therapy, 2019
  10. Iron Deficiency and Diffuse Nonscarring Scalp Alopecia in Women: More Pieces to the Puzzle Journal of the American Academy of Dermatology, 2010
  11. No Association Between Serum Ferritin Levels >10 Microg/l and Hair Loss Activity in Women Dermatology, 2008
  12. The Metabolic Processes of Folic Acid and Vitamin B12 Deficiency Journal of Health Research, 2014
  13. Reversible Cutaneous Hyperpigmentation and Nails With White Hair due to Vitamin B12 Deficiency European Journal of Dermatology, 2007
  14. NonScarring Diffuse Hair Loss in Women: A Clinico‐Etiological Study From Tertiary Care Center in North‐West India Journal of Cosmetic Dermatology, 2018
  15. Impact of Thyroid Dysfunction on Hair Disorders Cureus, 2023
  16. Clinicoepidemiological Observational Study of Acquired Alopecias in Females Correlating With Anemia and Thyroid Function Dermatology Research and Practice, 2016

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