The Assessment of Skin Color and Iron Levels in Pediatric Patients with β-Thalassemia Major Using a Visual Skin Color Chart

Abstract

Patients with β-thalassemia major (β-TM), a disease that emerges due to disorder of hemoglobin (Hb) synthesis, require life-long erythrocyte transfusion. The purpose of this study was to evaluate skin color and iron levels of patients with β-TM using a visual skin color chart. Each patient's skin color was matched on a skin color chart under a fluorescent lamp by the same physician on each occasion. Iron, iron binding capacity, ferritin and complete blood count (CBC) were studied for each patient enrolled. Colors marked on the visual skin color chart were compared with the laboratory results. Thirty-five patients being monitored at our hospital were included, 19 (54.3%) males and 16 (45.7%) females. The colors marked on the chart darkened as patients aged (p = 0.002, r = 0.49), the frequency of annual transfusions (p = 0.022, r = 0.385), ferritin levels (p < 0.001, r = 0.72) and iron levels increased (p = 0.001, r = 0.538) and as total iron binding capacity (TIBC) decreased (p < 0.001, r = -0.709). On the basis of this study, iron deposition in patients with β-TM was correlated with the colors on the chart.

Identifying Gingival Pigmentation Patterns and Skin Color and Its Co-relation With Serum Ferritin Levels in Thalassemic Patients

“…Spectrometry was used to confirm high iron deposition in the skin of patients with β-TM [ 32 ]. Bucak et al also revealed significant findings between the visual skin color chart (VSCC) and the iron parameters of β-TM patients [ 14 ].…”

“…Dermatological manifestations of patients with β-TM are darkened skin color and gingival hyperpigmentation due to iron overloading [ 5 ]. It is seen that there is a direct correlation between skin color and body iron levels in patients with β-TM [ 14 ]. Oral manifestations of thalassemia are malocclusion, high caries index, mucosal pallor, severe gingivitis, inflammation of salivary glands, thin mandibular cortex, multiple diastemas, spike-shaped and short roots, taurodontism, and dark-colored gingiva [ 15 ].…”

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“…Furthermore, age (p = 0.002) and the number of transfusions received yearly (p = 0.022) were shown to be associated with darker skin tones. Our review of the literature revealed no previous studies using a VSCC to evaluate skin color and iron values in people with β-thalassemia (30).…”