RESUMO
BACKGROUND: Androgenetic alopecia (AGA) is the most common form of alopecia, affecting 50% of the adult population world-wide. The exact mechanisms of this common hair disorder are yet to be fully elucidated. It is believed to be related to high circulating androgen levels in the blood and it is genetically determined. Deficiencies of micronutrients such as iron in the development of AGA have been a subject of debate. OBJECTIVE: This study sought to determine the association between serum ferritin levels and androgenetic alopecia among patients attending the Dermatology clinic at a tertiary health facility in South-Western Nigeria. METHODS: This was a hospital based cross sectional study with a total of 114 participants, which consisted of 57 subjects with AGA and 57 age and sex-matched healthy adults without AGAwho met the inclusion criteria. The diagnosis of AGA was made clinically and with the aid of a Dermatoscope (Wi-Fi Digital Microscope RoHS YPC_X03 V2018, HD Colour CMOS sensor with 50X-1000X magnification and HD resolution 1920x1080P). RESULTS: The mean age of the study participants was 41.68 ± 12.86 years with age ranging from 24 to 80 years. The mean serum ferritin levels among the subjects and control group were 188.65 ±97.92ng/ml and 194.49 ± 76.67ng/ml respectively but this difference was not statistically significant (p = 0.724). However, subjects with premature AGA had a significantly lower serum ferritin level compared to those with adult-onset AGA (p = 0.020). CONCLUSION: Iron deficiency is known to cause quantitative defect in haemoglobin production, limiting the amount of oxygen transported for hair growth and this, in addition to genetic factors, may explain why individuals with premature AGA have a significantly low serum ferritin levels.
CONTEXTE: L'alopécie androgénétique (AGA) est la forme la plus courante d'alopécie, affectant 50% de la population adulte dans le monde. Les mécanismes exacts de ce trouble capillaire commun n'ont pas encore été entièrement élucidés. On pense qu'il est lié à des taux élevés d'androgènes circulants dans le sang et qu'il est génétiquement déterminé. Les carences en micronutriments tels que le fer dans le développement de l'AGA ont fait l'objet de débats. OBJECTIF: Cette étude a cherché à déterminer l'association entre les niveaux de ferritine sérique et l'alopécie androgénétique chez les patients fréquentant la clinique de dermatologie d'un établissement de santé tertiaire du sud-ouest du Nigeria. MÉTHODES: Il s'agissait d'une étude transversale en milieu hospitalier avec un total de 114 participants, dont 57 sujets atteints d'AGA et 57 adultes en bonne santé, appariés selon l'âge et le sexe, sans AGA, qui répondaient aux critères d'inclusion. Le diagnostic de l'AGA a été établi cliniquement et à l'aide d'un dermatoscope (microscope numérique Wi-Fi RoHS YPC_X03 V2018, capteur CMOS couleur HD avec un grossissement de 50X-1000X et une résolution HD 1920x1080P). RÉSULTATS: L'âge moyen des participants à l'étude était de 41,68 ± 12,86 ans avec un âge allant de 24 à 80 ans. Les taux moyens de ferritine sérique chez les sujets et le groupe témoin étaient respectivement de 188,65 ± 97,92ng/ml et 194,49 ± 76,67ng/ml mais cette différence n'était pas statistiquement significative (p = 0,724). Cependant, les sujets atteints d'AGA prématurée avaient un taux de ferritine sérique significativement plus bas que ceux atteints d'AGA à l'âge adulte (p = 0,020). CONCLUSION: La carence en fer est connue pour provoquer un défaut quantitatif dans la production d'hémoglobine, limitant la quantité d'oxygène transportée pour la croissance des cheveux et ceci, en plus des facteurs génétiques, peut expliquer pourquoi les individus atteints d'AGA prématuré ont un taux de ferritine sérique significativement bas. Mots clés: Alopécie androgénétique, chute de cheveux, micronutriments, fer, ferritine, Nigeria.
Assuntos
Alopecia , Androgênios , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Alopecia/epidemiologia , Alopecia/diagnóstico , Alopecia/etiologia , Estudos Transversais , Ferritinas , Hemoglobinas , Ferro , Micronutrientes , Nigéria/epidemiologia , OxigênioRESUMO
The initial clinical manifestations of COVID 19 in Wuhan was fever, cough and shortness of breath but early reports in Italy and Spain preceded emerging literature of skin involvement. COVID19 was first reported in December, 2019 and after several observations of cutaneous involvement in patients with the disease there was need to document such in literature. The details of the clinical presentation and the pathophysiological mechanisms of these cutaneous lesions are, however, still poorly understood. This is a review of twenty-four published scientific articles summarizing the various cutaneous features observed by the frontline health care givers involved in the management of patients with Covid-19. Maculopapular exanthem was the most common pattern reported, accounting for 44.4% of skin manifestations. The pseudo-chilblain, urticarial, vesicular, livedoid and Kawasaki-like disease patterns accounted for 18.1%, 17.6%, 12.9%, 5.1% and 1.9% respectively. Anumber of the patients (9.5%) developed skin lesions at the time of diagnosis of Covid-19 or at the onset of Covid-19 respiratory symptoms while 75.1% developed the lesions after the onset of Covid-19 respiratory symptoms or after laboratory diagnosis of the disease had been made. There is no gainsaying that apart from the respiratory and other reported systems, Covid-19 also affects the skin. Clinicians, especially dermatologists, should therefore watch out for the already reported skin lesions and for possible yet to be discovered or reported skin lesions in patients with Covid-19. Dermatologists must bear in mind that patients presenting at skin clinics may actually be infected with Covid-19.