Serum ferritin levels in non-scarring alopecia of women: a case-control study

Iron deficiency in the etiology of hair loss has been studied for more than 45 years. However, contradictory reports have been published and almost all the studies conducted so far are based on observational methodology. To find out if any real association exists between the iron deficiency and alopecia. One hundred consecutive, clinically typical female patients [14-54 years] with nonscarring alopecia i.e. alopecia areata, androgenetic alopecia and telogen effluvium and an equal number of age- and sex-matched controls were included in the study. Both groups were evaluated for serum ferritin and other important parameters of iron status. Mean serum ferritin value of cases was significantly lower than that of the controls [p=0.005]. Patients with alopecia areata and androgenetic alopecia had significantly lower values of serum ferritin [p=0.011 and 0.015, respectively], but there was no significant difference in telogen effluvium cases and controls [p=0.348]. The values of hemoglobin, hematocrit, MCV, MCH and transferring-saturation were significantly lower in cases but had significantly higher TIBC values than controls. There is a definite association of decreased serum ferritin levels and nonscarring alopecia in women. The iron stores of female patients with nonscarring alopecias should be built for the optimum response to treatment as the proposed triggering factor can be abolished

Systemic amyloidosis presenting as mucocutaneous bullous lesions

A 65-year-old male presented with hemorrhagic bullous skin lesions with purpura and ecchymoses. There was increased skin fragility with a strongly positive Nikolsky sign. Histopathology of the skin revealed large amounts of amyloid deposits in the dermis with a positive Congo Red staining around the dermal vessels. Examination and tests in this patient also revealed anemia, hepatomegaly, infiltrative cardiomyopathy, polyneuropathy and immunoglobulin lamda deposition, favoring a diagnosis of primary amyloidosis [AL type]. The present case is reported in view of the rarity of the bullous variant of primary systemic amyloidosis as well as presence of mucosal lesions and a positive Nikolsky sign