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Kazan D, Özkoca D, Dizen Namdar N. The Difference Between SARS-CoV-2 Associated Telogen Effluvium and Telogen Effluvium Due to Other Causes. Dermatol Pract Concept 2024; 14:dpc.1403a170. [PMID: 39122542 PMCID: PMC11314756 DOI: 10.5826/dpc.1403a170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Telogen effluvium (TE) is a common type of non-cicatricial alopecia, and it is reported frequently in patients with SARS-CoV-2 infection. OBJECTIVES Herein, we aimed to examine the demographic, dermoscopic, and laboratory features of the patients with SARS-CoV-2 associated TE (CATE) and compare them with TE due to other causes (TEDOC) according to these features. METHODS In this retrospective case-control study we evaluated the patients who were diagnosed with TE and were above 18 years of age between April and June 2022. The patients were divided into two groups based on their medical history and SARS-CoV-2 PCR positivity. The first group included patients with CATE and positive SARS-CoV-2 PCR test results in the last 3 months. The second group consisted of patients with TEDOC. Patients gender, age, disease duration, additional systemic disease, dermoscopic findings, and laboratory results were recorded. RESULTS A total of 92 patients, 86 (93.5%) females, and 6 (6.5%) males, were included in the study. CATE was detected in 52 (56.5%) patients whereas 40 (44.5%) patients had TEDOC. The mean time between the onset of SARS-CoV-2 infection and hair loss complaint was calculated as 64.8 + 25.6 days, and this time was significantly shorter than patients with TEDOC (P = 0.003). The dermoscopic evaluation showed that empty follicular openings and yellow dots were statistically higher in patients with CATE, whereas short regrowing hair were markedly higher in patients with TEDOC (P = 0.001, P = 0.001,and P = 0.001, respectively) CONCLUSIONS: CATE is characterized by excessive hair-shedding that begins sooner after infection than classic TE. Dermoscopic findings can assist clinicians in diagnosis.
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Affiliation(s)
- Didem Kazan
- Kutahya Health Science University, Evliya Celebi Training and Research Hospital, Dermatology and Venerology Clinic, Kutahya, Turkey
- Istanbul Arel University, Department of Dermatology and Venerology, Istanbul, Turkey
| | - Defne Özkoca
- Zonguldak Atatürk State Hospital, Dermatology and Venerology Clinic, Zonguldak, Turkey
| | - Nazlı Dizen Namdar
- Kutahya Health Science University, Evliya Celebi Training and Research Hospital, Dermatology and Venerology Clinic, Kutahya, Turkey
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Bedair NI, Abdelaziz AS, Abdelrazik FS, El-Kassas M, AbouHadeed MH. Post Covid telogen effluvium: the diagnostic value of serum ferritin biomarker and the preventive value of dietary supplements. a case control study. Arch Dermatol Res 2024; 316:336. [PMID: 38844670 PMCID: PMC11156737 DOI: 10.1007/s00403-024-03004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/12/2024] [Accepted: 04/26/2024] [Indexed: 06/09/2024]
Abstract
Telogen effluvium is characterized by excessive hair shedding usually following a stressful event. Ferritin has been used in clinical practice as a biomarker of nonanemic iron deficiency in cases of telogen effluvium. During the years of the COVID19 pandemic, telogen effluvium was reported as a part of post covid manifestations. As ferritin was also a biomarker for inflammation in cases with covid infection, this study was designed to evaluate the value of ferritin in cases with postcovid telogen effluvium one hundred patients recovering from covid 19 for 4-12 weeks were included in the study, detailed drug and laboratory history was obtained and serum ferritin level was measured. the mean serum level of ferritin among telogen effluvium patients was significantly lower than controls (68.52 ± 126 and 137 ± 137.597 ug/L respectively). Patients with telogen effluvium used significantly more azithromycin and ivermectin and significantly less vitamin C, D, lactoferrin and zinc than the controls Although serum ferritin is lower among telogen effluvium patients, it was still higher than the cutoff value for diagnosing nonanemic iron deficiency, we suggest that it will not be a good biomarkers in these cases. Our secondary outcomes showed that dietary supplements used during active infection such as vitamin C, D, lactoferrin and zinc might have a preventive value on postcovid hair loss, while azithromycin and ivermectin could have a negative long term effect on telogen effluvium.
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Affiliation(s)
- Nermeen Ibrahim Bedair
- Department of Dermatology, Andrology, Sexual Medicine and STDs, Faculty of Medicine, Helwan University, Cairo, Egypt.
| | - Alaa Safwat Abdelaziz
- Department of Dermatology, Banha Educational Hospital, Ministry of Health, Banha, Egypt
| | | | - Mohamed El-Kassas
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Mohamed Hussein AbouHadeed
- Research Department of Dermatology and Venereology, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt
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Miot HA, Criado PR, Castro CCSD, Ianhez M, Talhari C, Ramos PM. Bibliometric evaluation of Anais Brasileiros de Dermatologia (2013-2022). An Bras Dermatol 2024; 99:90-99. [PMID: 37775437 DOI: 10.1016/j.abd.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/15/2023] [Accepted: 08/15/2023] [Indexed: 10/01/2023] Open
Abstract
The Anais Brasileiros de Dermatologia, published since 1925, is the most influential dermatological journal in Latin America, indexed in the main international bibliographic databases, and occupies the 50th position among the 70 dermatological journals indexed in the Journal of Citations Reports, in 2022. In this article, the authors present a critical analysis of its trajectory in the last decade and compare its main bibliometric indices with Brazilian medical and international dermatological journals. The journal showed consistent growth in different bibliometric indices, which indicates a successful editorial policy and greater visibility in the international scientific community, attracting foreign authors. The increases in citations received (4.1×) and in the Article Influence Score (2.9×) were more prominent than those of the main Brazilian medical and international dermatological journals. The success of Anais Brasileiros de Dermatologia in the international scientific scenario depends on an assertive editorial policy, on promptly publication of high-quality articles, and on institutional stimulus to encourage clinical research in dermatology.
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Affiliation(s)
- Hélio Amante Miot
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Universidade Estadual Paulista, Botucatu, SP, Brazil.
| | - Paulo Ricardo Criado
- Centro Universitário Faculdade de Medicina do ABC, Santo André, SP; and Faculdade de Ciências Médicas de Santos (Fundação Lusíada), Santos, SP, Brazil; Hospital de Dermatologia Sanitária do Paraná and Escola de Medicina, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | - Caio César Silva de Castro
- Department of Dermatology, Hospital de Doenças Tropicais de Goiás, Goiânia, GO, Brazil; Department of Dermatology, Universidade do Estado do Amazonas, Manaus, AM, Brazil
| | - Mayra Ianhez
- Department of Dermatology, Hospital de Doenças Tropicais de Goiás, Goiânia, GO, Brazil
| | - Carolina Talhari
- Department of Dermatology, Universidade do Estado do Amazonas, Manaus, AM, Brazil
| | - Paulo Müller Ramos
- Department of Infectology, Dermatology, Diagnostic Imaging and Radiotherapy, Universidade Estadual Paulista, Botucatu, SP, Brazil
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Triwongwaranat D, Thanomkitti K, Korviriyakamol T, Saengthong-Aram P, Varothai S, Thuangtong R. Characteristics of hair loss in COVID-19 patients in Thailand. Medicine (Baltimore) 2023; 102:e36539. [PMID: 38065902 PMCID: PMC10713103 DOI: 10.1097/md.0000000000036539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
There is still a scarcity of data on hair loss caused by coronavirus disease 2019 (COVID-19) infection. This study aims to determine the characteristics of hair loss in Thai individuals after COVID-19 infection and to identify associated factors. From March to June 2022, a retrospective review of medical records and telephone interviews was conducted to determine the details of hair loss, the severity of infection, and the associated treatments of patients with an abrupt onset of hair loss after the diagnosis of COVID-19 infection at Siriraj Hospital in Bangkok, Thailand. This study included 43 patients who experienced hair loss within 4 months after COVID-19 infection. The mean age was 46.5 ± 14.5 years, predominantly women. Most had mild COVID-19 symptoms (59.3%), and 59.1% experienced weight loss, with a mean weight loss of 4.3 ± 2.0 kg per month. Preexisting hair loss was reported in 31.0% of participants, with approximately 3-quarters diagnosed with androgenetic alopecia. The median onset of hair loss after COVID-19 infection was 30 days (interquartile range 30-60). Telogen effluvium was the most common acute hair loss diagnosis, and topical minoxidil was the predominant treatment (95.3%). Female gender was correlated with a more severe shedding scale (adjusted odd ratio 24.76, 95% CI 1.67-168.86). Patients with a history of androgenetic alopecia tended to have a lower hair shedding scale (adjusted odd ratio 0.03, 95% CI 0.01-0.38). This study reviewed the characteristics of hair loss after COVID-19 infection during Omicron outbreaks in Thailand. The COVID-19-associated telogen effluvium, which is the primary cause in our patients, manifested with earlier onset at approximately 30 days.
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Affiliation(s)
- Daranporn Triwongwaranat
- Department of Dermatology, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanchalit Thanomkitti
- Department of Dermatology, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tarinee Korviriyakamol
- Department of Dermatology, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phuwakorn Saengthong-Aram
- Department of Dermatology, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supenya Varothai
- Department of Dermatology, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Rattapon Thuangtong
- Department of Dermatology, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Bukhari AE, AlDosari DA, AlDosari MA, Muqrin RF, Moazin OM, Almutlq MM, Altalhab SM, Alharithy RS, Alkhalifah AI. COVID-19-induced hair shedding and related risk factors: A Saudi perspective. J Family Med Prim Care 2023; 12:3304-3311. [PMID: 38361868 PMCID: PMC10866268 DOI: 10.4103/jfmpc.jfmpc_314_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction Many cases of telogen effluvium (TE), acute hair shedding, following coronavirus disease 2019 (COVID-19) were reported during the pandemic. Methodology We conducted a cross-sectional study to assess the relationship between COVID-19 and TE in Saudi Arabia. Self-administered online questionnaires were distributed online between March and September 2022 in Saudi Arabia. A multivariate logistic regression model was used to determine risk factors associated with TE post-COVID-19 (significance at P < 0.05). Results Of the 703 responders, 392 were included in the study. 59.70% (n = 234) recognized hair shedding during or after COVID-19. The time taken to realize hair shedding (3 or 6 months) and the duration varied (3, 6, >6 months). The risk factors significantly related to TE post-COVID-19 were: female sex (P < 0.001, odds ratio [OR] = 2.98), COVID-19 antiviral treatment (P = 0.032, OR = 3.02), and TE history (P = 0.001, OR = 3.78). Conclusion Healthcare providers and physicians should be aware of the relationship between TE and COVID-19, to easily recognize, treat, and improve their patients' outcomes).
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Affiliation(s)
- Abrar E. Bukhari
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Dalal A. AlDosari
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Manal A. AlDosari
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Reema F. Muqrin
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Othillah M. Moazin
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Malak M. Almutlq
- Department of Dermatology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Saad M. Altalhab
- Department of Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Ruaa S. Alharithy
- Department of Dermatology, Princess Nourah Bint Abdul Rahman University, Security Forces Hospital, Riyadh, Saudi Arabia
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Aboalola D, Aouabdi S, Ramadan M, Alghamdi T, Alsolami M, Malibari D, Alsiary R. An Update on Alopecia and its Association With Thyroid Autoimmune Diseases. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:54-59. [PMID: 38187080 PMCID: PMC10769472 DOI: 10.17925/ee.2023.19.2.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/30/2023] [Indexed: 01/09/2024]
Abstract
Alopecia is comorbid with several illnesses, including various autoimmune conditions such as thyroid disease. Leukocyte-mediated inflammation of hair follicles in alopecia was first described over a century ago. However, the high prevalence of the role of thyroid autoimmune disease in the pathogenesis of alopecia has only recently come to light, together with a strong association between the two. Therefore, this review focuses on articles published between 2011 and 2022 on alopecia's association with thyroid autoimmune disease, and the mechanism behind it. In addition, it highlights the link between alopecia and thyroid cancer, as patients with alopecia have increased risk of thyroid cancer. In conclusion, this comprehensive, focused, scoping review will serve as a reference highlighting recent information on alopecia, exploring its association with thyroid autoimmune diseases.
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Affiliation(s)
- Doaa Aboalola
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Sihem Aouabdi
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Majed Ramadan
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Tariq Alghamdi
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Mona Alsolami
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Dalal Malibari
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
| | - Rawiah Alsiary
- King Abdullah International Medical Research Center, Jeddah, Western Region, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Western Region, Saudi Arabia
- Ministry of National Guard Health Affairs, Jeddah, Western Region, Saudi Arabia
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Chrabieh R, Haddad I, Salameh P, Kurban M, Kechichian E, Habre M, Ayoub N, Torbey G, El Sayed F, Maamari M, Tannous Z, Farra A, El Khoury J. Dermatological manifestations associated with COVID-19 and COVID-19 vaccination: results from the Lebanese COVID registry. Int J Dermatol 2023; 62:1248-1256. [PMID: 37638543 DOI: 10.1111/ijd.16815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/22/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND A number of cutaneous manifestations and adverse cutaneous reactions have been associated with COVID-19 infection and vaccine. OBJECTIVES A Lebanese national registry was established to characterize the dermatologic manifestations and adverse cutaneous reactions associated with COVID-19 infection and vaccination in a sample of the Lebanese population. METHODS An observational cross-sectional study was conducted via a web-based clinical form distributed to physicians wishing to report their cases from May 2021 till May 2022. RESULTS In total, 142 patients were entered in the registry, of which 133 were adults and nine were pediatric patients. The main dermatological manifestations reported with COVID-19 infection in the adult group were urticaria (32.9%), telogen effluvium (21.4%), morbilliform (10%), and papulosquamous (8.6%) eruptions. Urticaria was the most common adverse cutaneous reaction to the vaccine (33%). Interestingly, herpes zoster was triggered in 12 patients post vaccination in our series with this finding more frequently seen in patients above the age of 41 (P = 0.013). In the pediatric group, the most reported dermatological findings associated with COVID-19 infection were malar erythema (25%) and telogen effluvium (25%). One 16-year-old patient developed lichen planus after one dose of a COVID-19 vaccine. No deaths were reported in both age groups. CONCLUSION This Lebanese registry adds more robust evidence that clinical manifestations of the COVID-19 virus and vaccine are diverse. More studies are necessary to establish the pathophysiology of these dermatological findings in the context of COVID-19 infection and vaccination.
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Affiliation(s)
- Remie Chrabieh
- Department of Dermatology, Gilbert and Rose Marie school of Medicine, Lebanese American University, Beirut, Lebanon
| | - Isabelle Haddad
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Medicine, Lebanese American University, Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417, Nicosia, Cyprus
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
| | - Mazen Kurban
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elio Kechichian
- Department of Dermatology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
- Department of Dermatology, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, QC, Canada
| | - Maya Habre
- Department of Dermatology, Faculty of Medicine, Saint George University of Beirut, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Nakhle Ayoub
- Department of Dermatology, Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Gretta Torbey
- Department of Dermatology, Faculty of Medical Sciences, Lebanese University, Baabda Governmental University Hospital, Baabda, Lebanon
| | - Fouad El Sayed
- Department of Dermatology, Faculty of Medical Sciences, Lebanese University, Baabda Governmental University Hospital, Baabda, Lebanon
| | | | - Zeina Tannous
- Department of Dermatology, Gilbert and Rose Marie school of Medicine, Lebanese American University, Beirut, Lebanon
| | - Anna Farra
- Department of Internal Medicine, Division of Infectious Diseases, Gilbert and Rose Marie School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Jinane El Khoury
- Department of Dermatology, Gilbert and Rose Marie school of Medicine, Lebanese American University, Beirut, Lebanon
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Wadhwa D, Monga A, Kumar N, Khullar G, Karmakar S, Khunger N. A Cross-Sectional Study on Post-Coronavirus Disease (COVID-19) Hair Loss at a Tertiary Care Hospital. Dermatol Pract Concept 2023; 13:dpc.1304a263. [PMID: 37992388 PMCID: PMC10656157 DOI: 10.5826/dpc.1304a263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION Severe acute respiratory virus syndrome coronavirus 2 (SARS-CoV-2) was responsible for coronavirus disease (COVID-19) pandemic. As patients recovered from COVID-19 infection, hair loss was increasingly observed as a distressing symptom. METHODS This was a cross-sectional study of patients with post COVID-19 hair loss between July to December 2021 at a tertiary care center. Detailed history, clinical examination, trichoscopy and biochemical tests were performed and recorded. COVID-19 disease severity was assessed based on duration of COVID-19 infection and place of management. RESULTS The study included 120 patients with a mean age of 39.6 years. The majority of the patients were females treated at home and had COVID-19 infection for >2 weeks. The mean visual analog scale (VAS) score for stress was 5.25. Vitamin D deficiency was present in 56.7% and low ferritin in 30% of cases. The mean time of onset of hair loss post COVID-19 was 49 days. Patients mainly presented with diffuse hair loss. Trichodynia was present in 15.8% of cases. The degree of hair loss was severe in 55.8% of the subjects. Positive hair pull test was seen in 65% of patients. Most common trichoscopic features included single hair follicles (81.7%) and vellus hair >10% (60%). CONCLUSIONS The mean time of onset of hair loss post COVID-19 infection was less than 2 months. Majority patients had diffuse pattern and severe degree of hair loss. Trichoscopy can aid in unmasking co-existing patterned hair loss in patients presenting clinically with diffuse hair loss.
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Affiliation(s)
- Dhaarna Wadhwa
- Department of Dermatology and STD, Vardhman Mahavir Medical College and Safdarjung hospital, New Delhi, India
| | - Avneet Monga
- Department of Dermatology and STD, Vardhman Mahavir Medical College and Safdarjung hospital, New Delhi, India
| | - Neha Kumar
- Department of Dermatology and STD, Vardhman Mahavir Medical College and Safdarjung hospital, New Delhi, India
| | - Geeti Khullar
- Department of Dermatology and STD, Vardhman Mahavir Medical College and Safdarjung hospital, New Delhi, India
| | - Sanchita Karmakar
- Department of Dermatology and STD, Vardhman Mahavir Medical College and Safdarjung hospital, New Delhi, India
| | - Niti Khunger
- Department of Dermatology and STD, Vardhman Mahavir Medical College and Safdarjung hospital, New Delhi, India
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Comorbidities in Androgenetic Alopecia: A Comprehensive Review. Dermatol Ther (Heidelb) 2022; 12:2233-2247. [PMID: 36115913 PMCID: PMC9483356 DOI: 10.1007/s13555-022-00799-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/18/2022] [Indexed: 11/06/2022] Open
Abstract
Androgenetic alopecia is the most common form of hair loss, affecting 85% of men and 40% of women. Androgenetic alopecia is a disease caused by multiple factors, such as genetics, hormones, and systemic diseases; however, the exact cause remains undetermined. Recent studies have found that it is associated with a high incidence of endocrine diseases and other comorbidities. It may not only be a skin disease but also an early signal of underlying systemic diseases. Effective management requires timely diagnosis and treatment initiation. However, in current clinical practice, androgenetic alopecia is still not fully understood or treated. Recognizing the true physical, social, and emotional burden of androgenic alopecia, as well as its associated comorbidities, is the first step in improving the prognosis of affected patients. This review aimed to gather the known pathological factors and provide a reference for clinical physicians to understand androgenetic alopecia and its comorbidities in depth, thereby enabling early recognition of the underlying systemic diseases and providing timely treatment.
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Czech T, Sugihara S, Nishimura Y. Characteristics of Hair Loss after COVID-19: Systematic Scoping Review. J Cosmet Dermatol 2022; 21:3655-3662. [PMID: 35801366 PMCID: PMC9349634 DOI: 10.1111/jocd.15218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/18/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022]
Abstract
While there are literature reporting increased incidence of hair loss in COVID-19 patients, insufficient evidence exists on the topic to date. This review aims to identify the existing evidence and clinical characteristics of hair loss with COVID-19 infection. Following the PRISMA Extension for Scoping Reviews, MEDLINE and EMBASE were searched for all peer-reviewed articles with relevant keywords including "Alopecia", "Telogen Effluvium (TE)" and "COVID-19" from their inception to November 20, 2021. A total of 26 articles, with 9 observational studies and 17 case reports or series (total of 58 cases) were included. Most studies dealt with TE. There were no clear trends between COVID-19 severity and the extent of hair loss. Analysis of the 58 cases also found similar results with most of the cases being female (82.8%), the median onset of hair loss of 2.0 months, and the median time to recovery of hair loss of 5.0 months with a resolution rate of 95%. While this systematic review revealed uncertainty and a lack of strong evidence regarding the association of COVID-19 and hair loss, hair loss in COVID-19 may mainly include TE and be reversible in nature. Future studies are warranted to determine the detailed pathophysiology and risk factors of hair loss in COVID-19, including possible roles of estrogen, progesterone, and pro-inflammatory cytokines.
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Affiliation(s)
- Torrey Czech
- Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA
| | - Satoru Sugihara
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, 2-5-1 Shikata-cho, Kitaku, Okayama, Japan
| | - Yoshito Nishimura
- Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA
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11
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Aryanian Z, Balighi K, Hatami P, Afshar ZM, Mohandesi NA. The role of SARS-CoV-2 infection and its vaccines in various types of hair loss. Dermatol Ther 2022; 35:e15433. [PMID: 35266262 PMCID: PMC9111640 DOI: 10.1111/dth.15433] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/05/2022] [Indexed: 11/26/2022]
Abstract
The prevalence of hair loss has increased during COVID-19. In this study, we review the current literature on incidence and characteristics of various types of COVID-19-related and COVID-19-vaccine- related hair loss including telogen effluvium, alopecia areata, friction alopecia and anagen effluvium. Regarding most of them, the more severe the infection, the more profound and prolonged the course of alopecia. However, the most important issue is reassuring the patients of the non-serious nature of this complication, since psychological support is the most important factor in the earlier resolution of the condition.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, School of Medicine Razi HospitalTehran University of Medical SciencesTehranIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
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12
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Yıldırım SK, Erbağcı E, Demirel Öğüt N. Evaluation of patients with telogen effluvium during the pandemic: May the monocytesberesponsible for post COVID-19 telogen effluvium? J Cosmet Dermatol 2022; 21:1809-1815. [PMID: 35201647 PMCID: PMC9115203 DOI: 10.1111/jocd.14883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/18/2022] [Indexed: 11/27/2022]
Abstract
Introduction Telogen effluvium (TE) is one of the causes of non‐scarring hair loss that occurred commonly 2–3 months after a triggering factor. It was reported that the incidence of TE increased during the COVID‐19 (coronavirus disease 2019) pandemic. However, to date, there is no study evaluating the status of COVID‐19 before the onset of hair loss in patients with TE. The aim of this study is to evaluate the patients with TE whether they had COVID‐19 or not before the onset of their hair loss and to compare the demographic and clinical characteristics and laboratory parameters of those with and without a history of COVID‐19. Method We conducted an observational cohort study of TE patients. The diagnosis of TE depended on anamnesis and physical examination of the patients. Also, hair pull test was performed. Demographic data and the results of COVID‐19 real‐time polymerase chain reaction (RT‐PCR) were recorded from the electronic medical records. Results Totally, 181 patients with TE were included in the study. Sixty‐four of patients (35.4%) had been diagnosed with COVID‐19 before the hair loss started. The median duration of development of hair loss was 2 months (range 1–11 months, IQR 3) after COVID‐19 diagnosis. In this group, 87.5% of patients (n = 56) had acute TE and 12.5% of patients (n = 8) had chronic TE. The rate of acute TE and the use of vitamin supplements were ignificantly higher (p < 0.001 and p = 0.027, respectively) and the monocyte count in peripheral blood was lower (p = 0.041) in the group diagnosed with COVID‐19. Discussion and Conclusion It was stated that monocytes and macrophages infected by SARS‐CoV‐2 can produce pro‐inflammatory cytokines that play a crucial role in the development of COVID‐19‐related complications. Also, it was suggested that the number of monocytes tends to be lower in the late recovery stage. The lower monocyte count in patients with a history of COVID‐19 in our study may be related to evaluating the patients in the late period of recovery and the migration of circulating monocytes to hair follicles. The history of COVID‐19 must be questioned in patients with TE. It should be kept in mind that hair loss that develops after COVID‐19 may be presented as chronic TE form too. The exact mechanisms of hair loss induced by COVID‐19 are not fully explained; the roles of monocytes on the hair follicles may be one of the responsible mechanisms.
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Affiliation(s)
- Sema Koç Yıldırım
- Department of Dermatology and Venereology, Uşak University Training and Research Hospital, Uşak, Turkey
| | - Ece Erbağcı
- Department of Dermatology and Venereology, Uşak University Training and Research Hospital, Uşak, Turkey
| | - Neslihan Demirel Öğüt
- Department of Dermatology and Venereology, Uşak University Training and Research Hospital, Uşak, Turkey
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13
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Tammaro A, Adebanjo GAR, Parisella FR, Luzi F, Scarabello A. The hair and nail manifestations of COVID-19. J Cosmet Dermatol 2022; 21:1339-1346. [PMID: 35032337 DOI: 10.1111/jocd.14774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/12/2021] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
Emerging literature evidence shows that the manifestations of the coronavirus disease 2019 (COVID-19), which is the disease caused by SARS-CoV-2, encompass alterations of the pulmonary, cardiovascular, gastrointestinal and neurological system. Moreover, hematologic and dermatologic manifestations have been documented. The aim of this review is to summarize the dermatologic manifestations of COVID-19 involving the hair and nails in a narrative way. A total of 1136 patients have been reported to have de-novo hair loss following COVID-19. Notably, 958 patients experienced telogen effluvium (TE) (female/male ratio = 3,86:1), two female patients experienced anagen effluvium and 176 people had alopecia areata (female/male ratio of 19:3). Ten patients were reported to have ungual changes following the infection with the novel coronavirus: the individuals affected were 6 women and 4 men. COVID-19 can be associated to hair and ungual manifestations. This review summarizes the evidence regarding the hair and ungual manifestations of COVID-19, which could be harnessed to better understand the clinical implications and pathophysiology of this disease that has been burdening society globally since December 2019.
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Affiliation(s)
- Antonella Tammaro
- NESMOS Dermatology Department, Sapienza University of Rome, Rome, Italy
| | | | | | - Fabiola Luzi
- NESMOS Dermatology Department, Sapienza University of Rome, Rome, Italy
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