COVID-19 Tanısı Alan Hastalarda Favipiravir Kullanım Durumu ile Telogen Effluvium Arasındaki İlişkinin Değerlendirilmesi
Öz
Favipiravir (FVP), viral RNA'ya bağımlı RNA polimerazın yarışmalı bir inhibitörüdür ve aynı zamanda bir pürin nükleozid analoğudur. SARS-CoV-2 virüsüne karşı antiviral aktivite üretir ve COVID-19'u tedavi etmek için kullanılmıştır. Telogen effluvium (TE), telogen faz sırasında saçın erken gelişimine bağlı olarak yaygın, iz bırakmayan bir dökülmedir. En yaygın nedenler ilaçlar, fizyolojik ve duygusal stres, ameliyat, yüksek ateş, kronik enfeksiyonlar, diyet, demir eksikliği ve sigaradır. Bu çalışmada son 1 yıl içinde koronavirüs tanısı alarak FVP tedavisi alan ve almayan hastaları sorgulayarak TE açısından anlamlı bir fark olup olmadığını araştırdık. Bu çalışmaya Karaman Eğitim ve Araştırma Hastanesi Deri ve Zührevi Hastalıklar polikliniğine saç dökülmesi şikayeti ile başvuran ve son bir yıl içinde COVID-19 tanısı konan 18-65 yaş arası hastalar dahil edildi. Pull testi pozitif olan hastalarda trikoskopi kullanarak TE tanısını doğruladık. FVP tedavisi alan ve almayan hastalar arasında TE ve diğer saç dökülme tipleri açısından fark olup olmadığını araştırdık. Çalışma için Karamanoğlu Mehmet Bey Üniversitesi etik kurul onayı alındı (16 Haziran 2022). Hastaların cinsiyet, komorbidite, pull testi ve trikoskobik bulgularının FVP kullanımına göre karşılaştırılması sonucunda FVP kullananların çoğunun kadın olduğu görüldü (p = 0.027). FVP kullanmayanlar arasında pozitif pull testi oranı anlamlı olarak daha yüksekti (p = 0.026). Çalışmamızda FVP kullanan hastalarda pull testinin anlamlı olarak daha düşük olması, FVP'nin TE gelişimi üzerinde hiçbir etkisinin olmadığını düşündürebilir.FVP'nin alopesi ve TE üzerine etkisi ile ilgili herhangi bir çalışmaya rastlamadık. Çalışmamızın bu açıdan da önemli olduğunu düşünüyoruz.
Anahtar Kelimeler
Destekleyen Kurum
yok
Kaynakça
- 1. Ganeshgaran G, Dubin DP, Gould DJ. Cutaneous manifestations of COVID-19: an evidence-based review. Am J Clin Dermatol. 2020 ;21(5):627–39.
- 2. Erdem HA, Korkmaz Ekren P, Çağlayan D, et al. Treatment of SARS-COV-2 pneumonia with favipiravir: Early results from the Ege University cohort. Turk J Med Sci 2020;912-20.
- 3. Agrawal U, Raju R, Udwadia ZF. Favipiravir: a new and emerging antiviral option in COVID-19. Med J Armed Forces India. 2020; 76(4): 370- 6.
- 4. Klingman A. Pathologic dynamics of human hair loss. I. Telogen effluvium. Arch Dermatol. 1961 ;83:175–98.
- 5. Hillmann K, Blume-Peytavi U. Diagnosis of hair disorders. Semin Cutan Med Surg 2009; 28(1):33-8.
- 6. Guarrera M, Semino M, Rebora A. Quantitating hair loss in women: a critical approach. Dermatology 1997;194(1):12-6.
- 7. Shapiro J, Wiseman M, Lui H. Practical Management of Hair Loss. Can Fam Physician 2000; 1469-77.
- 8. Ross EK, Vincenzi C, Tosti A: Videodermoscopy in the evaluation of hair and scalp disorders. J Am Acad Dermatol 2006;55:799-806.
- 9. Tosti A, Whiting D, Iorizzo M, et al: The role of scalp dermoscopy in the diagnosis of alopecia areata incognita. J Am Acad Dermatol 2008;59:64-7
- 10. Karadağ Köse Ö, Güleç AT: Clinical evaluation of alopecias using a handheld dermatoscope. J Am Acad Dermatol 2012;67:206-14.
- 11. Inui S, Nakajima T, Nakagawa K, et al: Clinical significance of dermoscopy in alopecia areata: analysis of 300 cases. Int J Dermatol 2008;47:688-93.
- 12. Avcı A, Avcı D, Özyurt K. Telogen effluviumlu 563 kadın hastada laboratuvar bulguları. Med J Bakirkoy. 2015;11:120-3.
- 13. Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J Am Acad Dermatol. 2006;54(5):824-44.
- 14. Domínguez-Santás M, Haya-Martínez L, Fernández-Nieto D, Jiménez-Cauhé J, Suárez-Valle A, Díaz-Guimaraens B. Acute telogen effluvium associated with SARSCoV-2 infection. Aust J Gen Pract. 2020; 26;49:49.
- 15. Mieczkowska K, Deutsch A, Borok J, Guzman AK, Fruchter R, Patel P, et al. Telogen effluvium: a sequela of COVID-19. Int J Dermatol. 2021 ;60(1):122–4.
- 16. Giulio R, Federico D, Anna C, Radi G, Bianchelli T, Molinelli E, et al. Telogen effluvium related to post severe Sars-Cov-2 Infection: clinical aspects and our management experience. Dermatol Ther. 2021;34(1): 14547.
- 17. Özden MG, Öztaş MO, Gülekon A, Gürer MA. Kadın olgularda yaygın saç kaybı ve eşlik eden bulgular. J Exp Clin Med. 2008;25(2):50-6.
- 18. Alotaibi MK. Telogen effluvium: a review. ijmdc. 2019;3(10):797– 801.
- 19.Çadırcı D, Kıvanç Terzi N,Denizli E, et al. Telogen Effluvium Tanılı Hastaların Geriye Dönük Değerlendirilmesi Retrospective Evaluation of Patients with The Diagnosis of Telogen Effluvium Harran Üniversitesi Tıp Fakültesi Dergisi (Journal of Harran University Medical Faculty) 2020;17(3):438-41. DOI: 10.35440/hutfd.827111.
- 20. Güngör S, Topal I, Gökdemir G. Telogen Effluviumlu Kadin Hastalarda Tiroid Otoimmünitesinin Degerlendirilmesi/Evaluation of Thyroid Autoimmunity in Female Patients with Telogen Effluvium. Turkiye Klinikleri J Med Sci. 2014;34(1):93-6.
- 21. Gerkowicz A, Chyl-Surdacka K, Krasowska D, Chodorowska G. The Role of Vitamin D in Non-Scarring Alopecia. Int J Mol Sci 2017; 18: 2653. PMID: 29215595
- 22. Karadağ AS, Ertuğrul DT, Tutal E, Akin KO. The role of anemia and vitamin D levels in acute and chronic telogen effluvium. Turk J Med Sci 2011;41(5):827-33.
- 23. Punyaratabandhu P, Vanitchpongphan S. Favipiravir-induced cutaneous adverse reactions in patients infected with COVID-19. Clin Exp Dermatol. 2022 Mar;47(3):573-577. doi: 10.1111/ced.14953. Epub 2021 Oct 24. PMID: 34592006; PMCID: PMC8653311.
- 24. Atak M, Farabi B, Akbayrak A, Berati K, Babar K. Acute generalized exanthematous pustulosis following treatment with favipiravir in a patient with COVID-19 without hydroxychloroquine use: Report of the first case. J Cosmet Dermatol 2021; 2387-9.
- 25. Çeviker SA, Şener A, Yüksel C et al. Acute urticaria with Angioedema in a patient with COVID-19 pneumonia: Favipiravir side effect or a rare cutaneous manifestation. Journal of Emergency Medicine Case Reports 2021; 12(2):65-67. DOI: 10.33706/jemcr.851107.
- 26. Rossi A, Magri F, Sernicola A, et al. Telogen Effluvium after SARS-CoV-2 Infection: A Series of Cases and Possible Pathogenetic Mechanisms. Skin Appendage Disord. 2021 8;21(5):1-5.
Evaluation of the Relationship between Favipiravir Use Status and Telogen Effluvium in Patients Diagnosed with COVID-19
Öz
Favipiravir (FVP) is a competitive inhibitor of viral RNA-dependent RNA polymerase and is also a purine nucleoside analogue. It produces antiviral activity against the SARS-CoV-2 virus and has been used to treat COVID-19. Telogen effluvium (TE) is a widespread, non-scarring shedding due to the early entry of hair during the telogen phase. The most prevalent causes are drugs, physiological and emotional stress, surgery, high fever, chronic infections, diet, iron deficiency, and smoking. In this study, we investigated whether there was a significant difference in terms of TE by questioning the patients who had coronavirus in the last 1 year, and who received and did not receive FVP treatment. This study included patients aged 18-65 years old who applied to the Karaman Training and Research Hospital, Dermatology, and Venereal Diseases outpatient clinic complaining of hair loss and having had COVID-19 in the last year. We confirmed the diagnosis of TE by using trichoscopy on patients with a positive pull test. We investigated whether there was a difference in terms of TE and other types of hair loss between patients who received FVP treatment and those who did not. For the study Karamanoglu Mehmet Bey University ethics committee approval was obtained (June 16, 2022). As a result of comparing the patients' gender, comorbidity, pull test, and thyroscopic findings according to the use of FVP, it was clear that most of the FVP users were women (p = 0.027). Among those who did not use FVP, positive pull test scores were significantly higher (p = 0.026). The fact that the pull test was significantly lower in patients in our study using FVP may suggest that FVP has no effect on TE’s development. We did not find any study on its effect on alopecia and TE. We think that our study is also important in this respect.
Anahtar Kelimeler
Kaynakça
- 1. Ganeshgaran G, Dubin DP, Gould DJ. Cutaneous manifestations of COVID-19: an evidence-based review. Am J Clin Dermatol. 2020 ;21(5):627–39.
- 2. Erdem HA, Korkmaz Ekren P, Çağlayan D, et al. Treatment of SARS-COV-2 pneumonia with favipiravir: Early results from the Ege University cohort. Turk J Med Sci 2020;912-20.
- 3. Agrawal U, Raju R, Udwadia ZF. Favipiravir: a new and emerging antiviral option in COVID-19. Med J Armed Forces India. 2020; 76(4): 370- 6.
- 4. Klingman A. Pathologic dynamics of human hair loss. I. Telogen effluvium. Arch Dermatol. 1961 ;83:175–98.
- 5. Hillmann K, Blume-Peytavi U. Diagnosis of hair disorders. Semin Cutan Med Surg 2009; 28(1):33-8.
- 6. Guarrera M, Semino M, Rebora A. Quantitating hair loss in women: a critical approach. Dermatology 1997;194(1):12-6.
- 7. Shapiro J, Wiseman M, Lui H. Practical Management of Hair Loss. Can Fam Physician 2000; 1469-77.
- 8. Ross EK, Vincenzi C, Tosti A: Videodermoscopy in the evaluation of hair and scalp disorders. J Am Acad Dermatol 2006;55:799-806.
- 9. Tosti A, Whiting D, Iorizzo M, et al: The role of scalp dermoscopy in the diagnosis of alopecia areata incognita. J Am Acad Dermatol 2008;59:64-7
- 10. Karadağ Köse Ö, Güleç AT: Clinical evaluation of alopecias using a handheld dermatoscope. J Am Acad Dermatol 2012;67:206-14.
- 11. Inui S, Nakajima T, Nakagawa K, et al: Clinical significance of dermoscopy in alopecia areata: analysis of 300 cases. Int J Dermatol 2008;47:688-93.
- 12. Avcı A, Avcı D, Özyurt K. Telogen effluviumlu 563 kadın hastada laboratuvar bulguları. Med J Bakirkoy. 2015;11:120-3.
- 13. Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J Am Acad Dermatol. 2006;54(5):824-44.
- 14. Domínguez-Santás M, Haya-Martínez L, Fernández-Nieto D, Jiménez-Cauhé J, Suárez-Valle A, Díaz-Guimaraens B. Acute telogen effluvium associated with SARSCoV-2 infection. Aust J Gen Pract. 2020; 26;49:49.
- 15. Mieczkowska K, Deutsch A, Borok J, Guzman AK, Fruchter R, Patel P, et al. Telogen effluvium: a sequela of COVID-19. Int J Dermatol. 2021 ;60(1):122–4.
- 16. Giulio R, Federico D, Anna C, Radi G, Bianchelli T, Molinelli E, et al. Telogen effluvium related to post severe Sars-Cov-2 Infection: clinical aspects and our management experience. Dermatol Ther. 2021;34(1): 14547.
- 17. Özden MG, Öztaş MO, Gülekon A, Gürer MA. Kadın olgularda yaygın saç kaybı ve eşlik eden bulgular. J Exp Clin Med. 2008;25(2):50-6.
- 18. Alotaibi MK. Telogen effluvium: a review. ijmdc. 2019;3(10):797– 801.
- 19.Çadırcı D, Kıvanç Terzi N,Denizli E, et al. Telogen Effluvium Tanılı Hastaların Geriye Dönük Değerlendirilmesi Retrospective Evaluation of Patients with The Diagnosis of Telogen Effluvium Harran Üniversitesi Tıp Fakültesi Dergisi (Journal of Harran University Medical Faculty) 2020;17(3):438-41. DOI: 10.35440/hutfd.827111.
- 20. Güngör S, Topal I, Gökdemir G. Telogen Effluviumlu Kadin Hastalarda Tiroid Otoimmünitesinin Degerlendirilmesi/Evaluation of Thyroid Autoimmunity in Female Patients with Telogen Effluvium. Turkiye Klinikleri J Med Sci. 2014;34(1):93-6.
- 21. Gerkowicz A, Chyl-Surdacka K, Krasowska D, Chodorowska G. The Role of Vitamin D in Non-Scarring Alopecia. Int J Mol Sci 2017; 18: 2653. PMID: 29215595
- 22. Karadağ AS, Ertuğrul DT, Tutal E, Akin KO. The role of anemia and vitamin D levels in acute and chronic telogen effluvium. Turk J Med Sci 2011;41(5):827-33.
- 23. Punyaratabandhu P, Vanitchpongphan S. Favipiravir-induced cutaneous adverse reactions in patients infected with COVID-19. Clin Exp Dermatol. 2022 Mar;47(3):573-577. doi: 10.1111/ced.14953. Epub 2021 Oct 24. PMID: 34592006; PMCID: PMC8653311.
- 24. Atak M, Farabi B, Akbayrak A, Berati K, Babar K. Acute generalized exanthematous pustulosis following treatment with favipiravir in a patient with COVID-19 without hydroxychloroquine use: Report of the first case. J Cosmet Dermatol 2021; 2387-9.
- 25. Çeviker SA, Şener A, Yüksel C et al. Acute urticaria with Angioedema in a patient with COVID-19 pneumonia: Favipiravir side effect or a rare cutaneous manifestation. Journal of Emergency Medicine Case Reports 2021; 12(2):65-67. DOI: 10.33706/jemcr.851107.
- 26. Rossi A, Magri F, Sernicola A, et al. Telogen Effluvium after SARS-CoV-2 Infection: A Series of Cases and Possible Pathogenetic Mechanisms. Skin Appendage Disord. 2021 8;21(5):1-5.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Orjinal Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mayıs 2023 |
| Kabul Tarihi | 27 Mart 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 13 Sayı: 3 |
