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Query: UMLS:C0240066 (iron deficiency)
 7,156 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Deficiency of nutritional iron represents a public health problem recognized throughout much of the world. The overall prevalence rate of patients with iron deficiency (ID) who need supplementary iron therapy ranges markedly from less than 10% to as high as 70% among various ethnic and socioeconomic groups. Dermatologically, the iron-deficit state can be a secondary condition or trigger a wide range of mucocutaneous alterations. Early appreciation of adverse cutaneous manifestations of ID seems to have commensurate significance not only in predicting the presence of undiagnosed ID, but also for providing specified avenues for rational therapeutic approaches to patients with ID. Dermatopathic anemia has attracted the attention of clinicians because ID was found to be a metabolic consequence of skin diseases such as erythroderma, exfoliative dermatitis, psoriasis, eczema, and many others. Previous studies had suggested that iron may be lost in accelerated turnover of the keratinocyte from scaling; currently, malabsorption of iron is accepted implication accounting for dermatopathic anemia. However, mucocutaneous affections adversely manifested by ID have not been extensively reviewed and published in the current dermatologic literature because of the potentially benign course of the adverse conditions and the limited degree of clinical expression. Therefore, changes in hair, nails, mucosa and tongue, pruritus, chronically sustained inflammation, dermatitis herpetiformis, and photodermatitis are among the adverse cutaneous sequelae whose relation to ID are highlighted and discussed in the present review. Because of their clinical and diagnostic importance, other extracutaneous physical signs of ID, such as blue sclerae and pica, are also included in this review.(ABSTRACT TRUNCATED AT 250 WORDS)
Semin Dermatol 1991 Dec
PMID:Iron deficiency: structural and microchemical changes in hair, nails, and skin. 176 60

The association of prurigo nodularis (PN) and macular amyloidosis (MA) has not been reported before. Although pruritus related frictional trauma is a well-known cause of PN, its role in the development of MA has always been questioned. We herein report two cases with chronic liver disease and iron deficiency who concomitantly developed MA and PN lesions. Pruritus was the preceding factor and both lesions were confined to scratched areas. The association of two otherwise uncommon dermatoses in pruritic patients and their characteristic distribution might indicate an important role for pruritus-induced scratching in the pathogenesis of MA, too.
Eur J Dermatol 2000 Jun
PMID:The combined occurrence of macular amyloidosis and prurigo nodularis. 1084 58

Chronic mucocutaneous candidiasis (CMC) is a primary immunodeficiency disease clinically characterized by Candida infection of the skin, mucous membranes, or nails that is refractory to traditional treatment. We present a typical case of a 13-year-old boy with an onset of illness at 1 month of age in the form of oral thrush. At age 2-3 years the patient began to have external otitis caused by Candida albicans and recurrent upper respiratory tract infections. Analytical studies detected iron deficiency and circulating antigliadin antibodies. Immunologic findings excluded other possible immunodeficiencies. Significant clinical improvement was produced by therapy with orally administered fluconazole. The significance of antigliadin antibodies is discussed.
Pediatr Dermatol
PMID:Antigliadin antibodies associated with chronic mucocutaneous candidiasis. 1238 98

Alopecia in women is a common problem, and conflicting observational data have failed to determine whether an association exists between alopecia and iron deficiency in women. We therefore utilized an analytical cross-sectional methodology to evaluate whether common types of alopecia in women are associated with decreased tissue iron stores, as measured by serum ferritin. We studied patients with telogen effluvium (n = 30), androgenetic alopecia (n = 52), alopecia areata (n = 17), and alopecia areata totalis/universalis (n = 7). The normal group consisted of 11 subjects without hair loss from the same referral base and source population as those patients with alopecia. We analyzed the data utilizing the unpaired Student's t test assuming unequal variances with an alpha adjustment for multiple comparisons to assess whether the mean ages, ferritin levels, and hemoglobin levels of women without hair loss differed from the means in each alopecia group. The mean age of patients and normals did not differ significantly. We found that the mean ferritin level (ng per ml [95% confidence intervals]) in patients with androgenetic alopecia (37.3 128.4, 46.1]) and alopecia areata (24.9 [17.2, 32.6]) were statistically significantly lower than in normals without hair loss (59.5 [40.8, 78.1]). The mean ferritin levels in patients with telogen effluvium (50.1 [33.9, 66.33]) and alopecia areata totalis/universalis (52.3 [23.1, 81.5]) were not significantly lower than in normals. Our findings have implications regarding therapeutics, clinical trial design, and understanding the triggers for alopecia.
J Invest Dermatol 2003 Nov
PMID:Decreased serum ferritin is associated with alopecia in women. 1470 88

Iron deficiency is the world's most common nutritional deficiency and is associated with developmental delay, impaired behavior, diminished intellectual performance, and decreased resistance to infection. In premenopausal women, the most common causes of iron deficiency anemia are menstrual blood loss and pregnancy. In men and postmenopausal women, the most common causes of iron deficiency anemia are gastrointestinal blood loss and malabsorption. Hemoglobin concentration can be used to screen for iron deficiency, whereas serum ferritin concentration can be used to confirm iron deficiency. However, the serum ferritin concentration may be elevated in patients with infectious, inflammatory, and neoplastic conditions. Other tests may be needed, such as erythrocyte zinc protoporphyrin concentration, transferrin concentration, serum iron concentration, and transferrin saturation. The cause of iron deficiency must be identified. If the patient is male, postmenopausal female, or has risk factors for blood loss, then the patient should be evaluated for sources of blood loss, especially gastrointestinal (eg, colon cancer). Several studies have examined the relationship between iron deficiency and hair loss. Almost all have addressed women exclusively and have focused on noncicatricial hair loss. Some suggest that iron deficiency may be related to alopecia areata, androgenetic alopecia, telogen effluvium, and diffuse hair loss, while others do not. Currently, there is insufficient evidence to recommend universal screening for iron deficiency in patients with hair loss. In addition, there is insufficient evidence to recommend giving iron supplementation therapy to patients with hair loss and iron deficiency in the absence of iron deficiency anemia. The decision to do either should be based on clinical judgment. It is our practice at the Cleveland Clinic Foundation to screen male and female patients with both cicatricial and noncicatricial hair loss for iron deficiency. Although this practice is not evidence based per se, we believe that treatment for hair loss is enhanced when iron deficiency, with or without anemia, is treated. Iron deficiency anemia should be treated. Treating iron deficiency without anemia is controversial. Treatment of nutritional iron deficiency anemia includes adequate dietary intake and oral iron supplementation. Excessive iron supplementation can cause iron overload and should be avoided, especially in high-risk patients such as those with hereditary hemochromatosis. Patients who do not respond to iron replacement therapy should undergo additional testing to identify other underlying causes of iron deficiency anemia.
J Am Acad Dermatol 2006 May
PMID:The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. 1731 91

Although head lice, Pediculus humanus capitis, are globally prevalent blood-sucking ectoparasites, the amount of blood imbibed by head lice has not been determined. This study investigated this parameter, as regular loss of a small quantity of blood may lead to an iron deficiency and anaemia. Adult female lice (66), adult males (46), and nymphs (152) were weighed before and after feeding in groups of 17-109 lice. The average amounts of blood imbibed at a single feed were: adult female louse (0.0001579 ml), adult male (0.0000657 ml) and nymph (0.0000387 ml). Assuming three feeds per day by an average infection of 30 lice (10 females, 10 males, and 10 nymphs), the average child with active pediculosis would loose 0.008 ml of blood per day. This amount of blood loss is of no clinical significance even in iron-deficient children. The most heavily infected child observed with 2657 lice could be expected to loose 0.7 ml/day or 20.8 ml/month, which may be of clinical importance in a child on an adequate diet, and would be significant in an iron-deficient child. However, if head lice feed more often than three times a day, a heavy infestation would have a greater potential to lead to iron deficiency. The frequency of feeding of head lice on the head of the human host needs to be determined.
Int J Dermatol 2006 May
PMID:Quantification of blood intake of the head louse: Pediculus humanus capitis. 1670 Jul 88

Iron deficiency has been suspected to represent one of the possible causes of excessive hair loss in women. The aim of our study was to assess this relationship in a very large population of 5110 women aged between 35 and 60 years. Hair loss was evaluated using a standardized questionnaire sent to all volunteers. The iron status was assessed by a serum ferritin assay carried out in each volunteer. Multivariate analysis allowed us to identify three categories: "absence of hair loss" (43%), "moderate hair loss" (48%) and "excessive hair loss" (9%). Among the women affected by excessive hair loss, a larger proportion of women (59%) had low iron stores (< 40 microg/L) compared to the remainder of the population (48%). Analysis of variance and logistic regression show that a low iron store represents a risk factor for hair loss in non-menopausal women.
Eur J Dermatol
PMID:Low iron stores: a risk factor for excessive hair loss in non-menopausal women. 1795 Nov 30

Although immunologic processes and hereditary factors are suggested to play an important role in alopecia areata, the specific etiology is unclear. Iron deficiency has been suggested to play a role, but its effect is controversial. In our case control study, we found a higher mean level of serum iron and ferritin and a lower mean level of TIBC in patients compared to control subjects, but the differences did not reach significance.
Dermatol Online J 2008 Mar 15
PMID:Evaluation of serum iron and ferritin levels in alopecia areata. 1862 22

Telogen effluvium (TE) is the most common cause of diffuse hair loss in adult females. TE, along with female pattern hair loss (FPHL) and chronic telogen effluvium (CTE), accounts for the majority of diffuse alopecia cases. Abrupt, rapid, generalized shedding of normal club hairs, 2-3 months after a triggering event like parturition, high fever, major surgery, etc. indicates TE, while gradual diffuse hair loss with thinning of central scalp/widening of central parting line/frontotemporal recession indicates FPHL. Excessive, alarming diffuse shedding coming from a normal looking head with plenty of hairs and without an obvious cause is the hallmark of CTE, which is a distinct entity different from TE and FPHL. Apart from complete blood count and routine urine examination, levels of serum ferritin and T3, T4, and TSH should be checked in all cases of diffuse hair loss without a discernable cause, as iron deficiency and thyroid hormone disorders are the two common conditions often associated with diffuse hair loss, and most of the time, there are no apparent clinical features to suggest them. CTE is often confused with FPHL and can be reliably differentiated from it through biopsy which shows a normal histology in CTE and miniaturization with significant reduction of terminal to vellus hair ratio (T:V < 4:1) in FPHL. Repeated assurance, support, and explanation that the condition represents excessive shedding and not the actual loss of hairs, and it does not lead to baldness, are the guiding principles toward management of TE as well as CTE. TE is self limited and resolves in 3-6 months if the trigger is removed or treated, while the prognosis of CTE is less certain and may take 3-10 years for spontaneous resolution. Topical minoxidil 2% with or without antiandrogens, finestride, hair prosthesis, hair cosmetics, and hair surgery are the therapeutically available options for FPHL management.
Indian J Dermatol Venereol Leprol
PMID:Diffuse hair loss in an adult female: approach to diagnosis and management. 1917 26

The relationship between nonscarring scalp alopecia in women and iron deficiency continues to be a subject of debate. We review the literature regarding the relationship between iron deficiency and nonscarring scalp alopecia and describe iron-dependent genes in the hair follicle bulge region that may be affected by iron deficiency. We conclude with a description of our approach to the diagnosis and treatment of nonscarring alopecia in women with low iron stores. Limitations include published studies with small numbers of patients, different study designs, and absence of randomized, controlled treatment protocols. Additional research regarding the potential role of iron during the normal hair cycle is needed, as is a well-designed clinical trial evaluating the effect of iron supplementation in iron-deficient women with nonscarring alopecia.
J Am Acad Dermatol 2010 Dec
PMID:Iron deficiency and diffuse nonscarring scalp alopecia in women: more pieces to the puzzle. 2088 66


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