Investigation of diffuse hair fall case due to vitamin D deficiency: a case report and literature review
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.
Keywords: vitamin D, diffuse hair loss, scalps
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