Investigation of diffuse hair fall case due to vitamin D deficiency: a case report and literature review
Abstract
A 45-year-old female from northern Sudan presented a complaint of diffuse hair loss from her scalp for 4 years. The condition started when she was in Saudi Arabia, where she resided for five years with her husband and children. The condition is associated with fatigability and easily falling asleep. The condition is static with no known relieving or aggravating factors. She looks well, not pale, jaundiced or cyanosed, regular pulse, no lymph node enlargement; thyroid is central with normal size and no lower limb edema.
Scalp: looks normal, no scales or erosions.
Hair: hair is dry with normal texture; loss is diffuse, no apparent patch of alopecia.
Axillary and pubic hair is normal. All investigations were within normal values except serum vitamin D that was found to be very low: 9 (average value 30–300). Management plans to correct the deficiency for three months, and then a daily maintenance dose is to be prescribed. The monitoring of vitamin D serum level is to be assessed to avoid hyper vitaminosis. Vitamin D supplement was prescribed as oral tabs of 50,000 IU weekly for three months. Daily maintenance dose of 1000 IU was prescribed. Improvement was noticed starting from the first month, and excellent result was achieved after three months of daily supplementation; daily maintenance dose was then prescribed with an advice of being outdoors to enhance endogenous synthesis.
Conclusion: Serum vitamin D level should be assessed in patients with hair loss, especially those at a risk because of being indoors.
References
[2] Calvo, M. S., Whiting, S. J., Barton, C. N. (February 2005). Vitamin D intake: A globalperspective of current status. The Journal of Nutrition, vol. 135, no. 2, pp. 310-316.
[3] Norman, A. W. (August 2008). From vitaminDtohormoneD:Fundamentalsofthe vitamin D endocrine system essential for good health. The American Journalof Good Nutrition, vol. 88, no. 2, pp. 491S-499S, PMID 18689389.
[4] Lab Tests Online (USA). Vitamin D Tests. American Association for Clinical chemistry.Retrieved June 23, 2013.
[5] Hollis, B. W. ( January 1996). Assessment of vitamin D nutritional and hormonalstatus: What to measure and how to do it. Calcified Tissue International, vol. 58,no. 1, pp. 4-5.
[6] Holick, M. F., Schnoes, H. K., DeLuca, H. F., et al. ( July 1971). Isolation andidentification of 1,25-dihydroxycholecalciferol. A metabolite of vitamin D active inintestine. Biochemistry, vol. 10, no. 14, pp. 2799-2804.
[7] NIH Office of Dietary Supplements. (February 11, 2016). Vitamin D. Retrieved June6, 2017.
[8] Olsen, E. A. (2001). Female pattern hair loss. Journal of the American Academy ofDermatology, vol. 45, pp. S70-S80.
[9] Tobin, D. J., Guinn, A., Magerl, M., et al. (2003). Plasticity and cytokinetic dynamicsof the hair follicle mesenchyme: Implications for hair growth control. Journal ofInvestigative Dermatology, vol. 120, pp. 895-904.
[10] Orme, S., Cullen, D., and Messenger, A. (1999). Diffuse female hair loss: Areandrogens necessary? British Journal of Dermatology, vol. 141, pp. 521-523.
[11] Olsen, E. (2003). Female pattern hair loss, in E. Olsen (ed.) Disorders of Hair Growth:Diagnosis and Treatment (2nd edition), pp. 338-339. New York, NY: McGraw-HillProfessional.
[12] Bolland, M. J., Ames, R. W., Grey, A. B., et al. (2008). Does degree of baldnessinfluence vitamin D status? The Medical Journal of Australia, vol. 189, nos. 11-12,pp. 674-675.
[13] Amor, K., Rashid, R., and Mirmirani, P. (2010). Does D matter? The role of vitamin Din hair disorders and hair follicle cycling. Dermatology Online Journal, vol. 16, no. 2,p. 3.
[14] Rasheed, H., Mahjoob, D., Hegazy, R., et al. (2013). Serum ferritin and vitamin D infemale hair loss: Do they play a role [Abstract]? Skin Pharmacology and Physiology,vol. 26, no. 2, pp. 101-107.
[15] Cerman, A. A., Solak, S. S., and Altunay, l. K. (March 2014). Vitamin D deficiency in
alopecia areata. British Journal of Dermatology, vol. 170, no. 6, pp. 1299-1304.[16] Holick, M. F., Binkley, N.C.,BischoffFerrari,H.A.,etal(July1,2011).Evaluation,treatment, and prevention of vitamin D deficiency: An Endocrine Society clinicalpractice guideline. The Journal of Clinical Endocrinology & Metabolism, vol. 96, no.7, pp. 1911-1930.