ASSOCIATION BETWEEN SERUM VITAMIN D3 LEVELS AND DURATION OF CHRONIC TELOGEN EFFLUVIUM IN FEMALES: A HOSPITAL-BASED CASECONTROL STUDY

Background: Chronic Telogen Effluvium (CTE) is a common non-scarring alopecia in women, characterized by persistent diffuse hair shedding. The etiopathogenesis is multifactorial, with emerging evidence implicating vitamin D3 in hair follicle cycling and keratinocyte proliferation. However, the relationship between serum vitamin D3 levels, chronicity of CTE, and the prevalence of associated dermatoses remains underexplored. Aim: To assess the association between serum vitamin D3 levels and the duration of CTE in females, and to evaluate the prevalence and vitamin D3 status of associated dermatoses in these patients. A hospital-based case-control study wa Methods: s conducted over 18 months, enrolling 62 female patients with CTE and 62 age-matched healthy controls. Detailed clinical history was recorded, including symptom duration, triggering events, and the presence of associated dermatoses (such as seborrheic capitis, premature canities, and acne vulgaris). Comprehensive clinical examination was performed, including hair pull and tug tests, followed by trichoscopic evaluation using DermLite DL4 to assess scalp and hair shaft features. Serum 25(OH)D levels were measured in all participants and classified according to Endocrine Society guidelines. Statistical analysis was conducted using SPSS v25. The mean serum vitamin D3 level was significantly lower in CT Results: E cases (18.31 ± 10.20 ng/ml) compared to controls (25.83 ± 9.67 ng/ml; p = 0.001). Vitamin D3 deficiency was observed in 66.1% of cases versus 25.8% of controls. Among CTE patients, 85.5% reported at least one trigger, with infective causes (COVID-19, dengue, typhoid) being the most common (30.6%), followed by crash dieting (21.0%), psychological stress (16.1%), and unknown factors (14.5%). The mean duration of hair loss was longest in the vitamin Dinsufficient group (17.5 ± 9.3 months), followed by the deficient (14.9 ± 7.1 months) and sufficient groups (11.7 ± 6.4 months). The hair pull test was positive in 61.3% of cases. Trichoscopic features characteristic of CTE included reduced hair diameter variability (<20% in 100% of cases) and the presence of tapered regrowing hairs (85.5%). A notable proportion of CTE patients (45.2%) exhibited associated dermatoses, with lower mean vitamin D3 levels recorded in these individuals compared to those without additional dermatoses (e.g., acne vulgaris: 12.3 ± 6.9 ng/ml; seborrheic capitis: 13.8 ± 5.6 ng/ml; premature canities: 12.1 ± 4.3 ng/ml). Patients without dermatoses had significantly higher mean vitamin D3 levels (24.2 ± 10.4 ng/ml). Conclusion: Suboptimal vitamin D3 levels are significantly associated with the presence and chronicity of CTE, as well as with the occurrence of associated dermatoses. These findings highlight the clinical value of routine vitamin D3 assessment in women presenting with diffuse hair loss, especially those with concurrent dermatological conditions, and suggest that correction of vitamin D3 deficiency may play a role in comprehensive management strategies.