LAUSR

Dear Editor Hair loss in children is one of the most common presentations in dermatology clinics that cause a significant distress to children and their parents. Telogen effluvium (TE) is the most common form of hair loss. When the condition lasts more than 6 months, it is considered chronic telogen effluvium (CTE). Pull test, trichogram, and trichoscopy are important tools for diagnosis of CTE and differentiating it from other causes of diffuse non cicatricial alopecia. In children, nutritional and endocrine disorders in addition to parasitic infestations are common risk factors that can affect health of skin and hair. We aimed to assess CTE in children and its relationship with other variables especially laboratory findings in a group of Egyptian children between 4 and 14 years. We included 70 subjects, 45 with CTE for more than 6 months, with positive pull test (telogen group), and 25 subjects in control group with chronic hair loss and negative pull test. Microscopic examination of hairs detached by pull test was done (Figures 1 and 2) to detect telogen hair and confirm the diagnosis of TE. For each subject, complete blood picture, TSH, Ferritin, and zinc analysis were assessed together with stool analysis. The mean age ± SD was (10.60 ± 2.77) years for telogen group, and (9.84 ± 3.08) years for control group. Out of 45 participants there were 40 females and five males. Laboratory investigations of telogen and control group are demonstrated in Table 1. Significant negative correlations were found between number of telogen hairs detected by microscopic examination and serum ferritin level and zinc level (Table 2). Table 3 shows higher hair shedding in anemic than non-anemic children in telogen group. In telogen group, we observed low serum ferritin and significant negative correlation were found between number of hairs detached by pull test and number of telogen hairs detected by microscopic examination and serum ferritin level. Serum ferritin is a sensitive marker for iron deficiency, Al-Refu proved that most common cause of hair loss in children was chronic illness followed by iron deficiency anemia. Most of studies discussing the link between diffuse hair loss and serum ferritin level were done in adults. A study showed that mean serum ferritin concentration was lower in the TE group compared to control group. Another study reported higher proportion of TE people with iron deficiency, indicated by deficient transferrin saturation.