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      Ischemia-modified albumin as a possible marker of oxidative stress in patients with telogen effluvium ☆☆

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          Abstract

          Background

          Telogen effluvium is the most common form of non-scarring alopecia characterized by diffuse hair loss. Ischemia-modified albumin is a marker of oxidative stress and inflammation.

          Objective

          The aim of this study was to compare the levels of ischemia-modified albumin of telogen effluvium patients with healthy controls.

          Methods

          Ninety-one patients diagnosed with telogen effluvium and 35 healthy volunteers were included in the study. Serum ischemia-modified albumin level was determined by a fast-colorimetric method, and albumin cobalt binding test. The results were evaluated statistically.

          Results

          There was no statistically significant difference between the serum albumin values of patient and control groups ( p = 0.739). Serum ischemia-modified albumin values were significantly higher in the patients with telogen effluvium than healthy controls ( p < 0.001).

          Study limitations

          Body mass index values of the patient and control groups could not be calculated.

          Conclusions

          To the best of the authors’ knowledge, this is the first clinical study to investigate the role of oxidative stress in the pathogenesis of telogen effluvium using ischemia-modified albumin as a biomarker. Based on the results of the present study, it can be considered that oxidative stress plays an important role in the pathogenesis of telogen effluvium. There is a need for further studies to support the results of this study, to demonstrate the possible effects of oxidative stress, and to investigate the other oxidative stress markers in the pathogenesis of telogen effluvium.

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          Most cited references26

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          Oxidative stress in malignant melanoma and non-melanoma skin cancer.

          Solar ultraviolet (UV) radiation is considered to be a major aetiological factor in melanoma and non-melanoma skin cancer. A growing body of evidence indicates that oxidative stress is involved in photocarcinogenesis. However, in vivo data for human skin are still lacking. Reactive oxygen species participate in a number of pathophysiological processes including DNA damage and lipid peroxidation (LPO) and are considered to be a key factor in tumour progression. We hypothesized that in human skin cancer the natural redox balance is disturbed and that this imbalance may result in an accumulation of LPO products. To test this, skin biopsies of superficial spreading melanoma were compared with age-matched benign melanocytic naevi and young healthy controls. Additionally, non-melanoma skin cancers (basal cell carcinoma, squamous cell carcinoma) and actinic keratosis were investigated (n = 18 each). Expression of the antioxidant enzymes, copper-zinc superoxide dismutase, manganese superoxide dismutase and catalase was analysed by immunohistochemical techniques. To detect LPO products, protein-bound malondialdehyde (MDA) was visualized. In human melanoma biopsies, a significant overexpression of the antioxidant enzymes was found when compared with surrounding non-tumour tissue, benign melanocytic naevi, and young controls. Intriguingly, the LPO marker MDA was significantly increased in melanoma tissue. MDA was located not only in typical melanoma cells, but also occurred in surrounding keratinocytes. In contrast, a severely disturbed antioxidant balance with diminished antioxidant enzymes was found in non-melanoma tumours, whereas MDA was elevated only in squamous cell carcinomas. These findings indicate that oxidative stress may play different roles in the pathogenesis of human skin cancers. In non-melanoma skin cancer, a diminished antioxidant defence caused by chronic UV exposure might contribute to multistep carcinogenesis, whereas melanoma cells exhibit increased oxidative stress which could damage surrounding tissue and thus support the progression of metastasis.
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            Telogen Effluvium: A Review.

            Telogen effluvium was first described by Kligman in 1961. It is a most common cause of diffuse hair loss. Women with telogen effluvium more frequently present to dermatologist. A wide variety of potential triggers have been implicated in the pathogenesis of telogen effluvium. Diffuse shedding of telogen hair are seen after 3-4 months of triggering event. The observation of increased telogen hair shedding does not infer a cause. Establishing aetiology of telogen effluvium requires elicitation of relevant history and appropriate laboratory investigations to exclude endocrine, nutritional and autoimmune disorders.
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              • Abstract: found
              • Article: not found

              Telogen effluvium. New concepts and review.

              Telogen effluvium is the result of a perturbation of the hair cycle that is manifest by increased loss of normal club hairs. Although diverse causes for telogen effluvium have been proposed, this article suggests several diverse mechanisms for the first time. Five different functional types of telogen effluvia are proposed based on changes in different phases of the follicular cycle. These are immediate anagen release, delayed anagen release, short anagen syndrome, immediate telogen release, and delayed telogen release. Diverse causes are confirmed and drug-related telogen effluvia are reviewed. The five diverse mechanisms proposed for telogen effluvia are generally confirmed and supported by clinical findings.
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                Author and article information

                Contributors
                Journal
                An Bras Dermatol
                An Bras Dermatol
                Anais Brasileiros de Dermatologia
                Sociedade Brasileira de Dermatologia
                0365-0596
                1806-4841
                06 May 2020
                Jul-Aug 2020
                06 May 2020
                : 95
                : 4
                : 447-451
                Affiliations
                [a ]Department of Medical Microbiology, Erol Olcok Education and Research Hospital, Hitit University, Çorum, Turkey
                [b ]Department of Dermatology, Faculty of Medicine, Hitit University, Çorum, Turkey
                [c ]Department of Urology, Erol Olcok Education and Research Hospital, Hitit University, Çorum, Turkey
                [d ]Department of Biochemistry, Ataturk Training and Research Hospital, Ankara, Turkey
                Author notes
                [* ]Corresponding author. unsalsavci@ 123456gmail.com
                Article
                S0365-0596(20)30123-9
                10.1016/j.abd.2020.01.005
                7335859
                32482549
                77171fb6-4e40-459f-a3a9-0f06c623bd92
                © 2020 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U.

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 May 2019
                : 10 January 2020
                Categories
                Investigation

                alopecia,inflammation,oxidative stress
                alopecia, inflammation, oxidative stress

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