The evaluation of the relationship between digital phototricogram findings with the TSH, ferritin and vitamin B12 levels in the blood of the patients with diffuse hair loss

ABSTRACT THE EVALUATION OF THE RELATIONSHIP BETWEEN DIGITAL PHOTOTRICOGRAM FINDINGS WITH THE TSH, FERRITIN AND VITAMIN B12 LEVELS IN THE BLOOD OF THE PATIENTS WITH DIFFUSE HAIR LOSS Telogen effluvium is a common type of alopecia seen in women. Such as endocrine disorders, eating disorders, stress, anemia, low ferritin level, vitamin B12 deficiency and thyroid disease are among the factors that cause hair loss. Various methods have been used in the evaluation of alopecia, but no ideal method has been found yet. One of the non invasive diagnostic methods developed in recent years is digital phototrichogram (Trichoscan). In this study, a comparison of digital phototrichogram (Trichoscan) results from the same patients was aimed, through measuring levels of ferritin, vit B12, and TSH in women patients with diffuse hair loss. The study included 108 female patients with diffuse hair loss. A detailed history of the patients was gained and hair pull test was conducted. Blood was taken from the patients to evaluate complete blood count, blood chemistry, serum iron, total iron binding capacity (TIBC), ferritin, thyroid stimulating hormone (TSH), free T3, free T4, folic acid and vitB12 level. The patients were divided into groups; acute and chronic telogen effluvium, also depending on their ferritin levels <40 ng/ml and >40 ng/ml. The telogen ratio, anagen ratio and hair density of patients were calculated with TrichoScan. The number of patients with chronic telogen effluvium was observed to be higher than those with acute telogen effluvium. And hair-pulling test positivity was observed to be higher in patients with KTE than in those with the ATE (p< 0.05). No significant correlation was seen in age and ferritin, vitB12, TSH, telogen ratio, anagen ratio and hair density (p> 0.05). The mean ferritin level was 25.55±19.20, the mean TSH level was 1.96±1.73 and the mean vitB12 level was found to be 313.57±116.79. In Trichoscan test, the mean telogen was %22.67±7.07, the mean anagen was %77.32±7.07 and the mean hair density was 209.61±42.64/cm2, respectively. The mean telogen ratio was higher in patients with ferritin levels < 40 ng/ml compared to those with > 40 ng/ml. Conversely, the mean anagen ratio was significantly lower (p< 0.05). No significant difference between the two groups was determined in hair density (p> 0.05). No significant correlation was found between the patients' vitB12, TSH levels and their Trichoscan findings (p> 0.05). In conclusion, TrichoScan findings were correlated with ferritin levels but were not corelated with vitamin B12 and TSH levels. We think that ferritin level has an important role in diffuse hair loss. We believe that Trichoscan method gives confidence to the patients and helps doctors in the diagnosis of telogen effluvium. Keywords: Digital phototrichogram, telogen effluvium, ferritin