Cutaneous Manifestations in Adult Thalassemia Patients
Narachai Julanon¹, Charoen Choonhakarn¹, Rachot Wongjirattikarn¹, Nattiya Teawtrakul², Suteeraporn Chaowattanapanit¹
Affiliation : ¹ Division of Dermatology, Department of Medicine, Khon Kaen University, Khon Kaen, Thailand; ² Division of Hematology, Department of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background: A wide range of cutaneous manifestations have been described in thalassemia patients. No studies have been conducted in Southeast Asia where there is a high prevalence of hemoglobin E (Hb E) thalassemia.
Objective: The primary objectives of the present study were to determine the prevalence of cutaneous manifestations among adult thalassemia patients and assess how cutaneous findings differ between patients with and without β-thalassemia (β-thal)/Hb E. Secondary objectives were to determine any associations between cutaneous manifestations and clinical or laboratory findings and to evaluate quality of life (QoL).
Materials and Methods: The present study was a cross-sectional descriptive study conducted between April 2021 and December 2022 in Thailand. Adults aged 18 years and older with any type of thalassemia were eligible. The authors collected relevant demographic data, cutaneous and laboratory findings, as well as responses to a validated Thai version of the Dermatology Life Quality Index (DLQI).
Results: One hundred patients (37% male) were included, with a median age of 33 (IQR of 24, 41) years. Of these, 76% had β-thal/Hb E. Xerosis was the most common cutaneous manifestation at 69%. Hyperpigmentation was more common in patients with β-thal/Hb E than those without at 41% versus 17% (p=0.031). Extramedullary erythropoiesis, xerosis, and serum ferritin were significantly associated with hyperpigmentation. The overall median DLQI score was 0 (IQR 0, 2).
Conclusion: Xerosis was the most common cutaneous findings in adult thalassemia patients, and hyperpigmentation was more common in patients with β-thal/Hb E. However, cutaneous changes had low impact on patients’ QoL.
Received 2 June 2023 | Revised 21 July 2023 | Accepted 25 July 2023
DOI: 10.35755/jmedassocthai.2023.10.13888
Keywords : Thalassemia; Cutaneous manifestations; Hemoglobin E thalassemia
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