Syphilis, is sexually transmitted disease caused by spirochete Treponema pallidum subsp.pallidum. It have many diverse clinical manifestations that occur in distinct stages. Early diagnosis and management are the main things to prevent transmission and complication. Direct test or morphological observation is the definitive diagnosis of syphilis. This can be done through animal inoculation test, dark field microscopy, direct fluorescence antibody (DFA), and nucleid acid amplification test (NAAT). While the indirect test is a nontreponemal serologic test consist of Wasserman test, venereal disease research laboratory (VDRL), toluidine red unheated serum test (TRUST), unheated serum reagin (USR), rapid plasma reagin (RPR) and treponemal serologic test, such as T. pallidum passive particle agglutination (TPPA), T. pallidum haemagglutination assay (TPHA), fluorescent treponemal antibody absorption (FTA-Abs), enzyme immunoassay (EIA) and rapid test. The algorithm of serologic test can be divided into traditional or reverse.

Background: Male androgenetic alopecia (MAGA), also known as androgenetic alopecia, is the most common hair loss in males who have a genetic predisposition. The pattern of baldness in MAGA starts from the frontal area in a triangular pattern, followed by progressive thinning of the vertex until baldness occurs. Generally, the diagnosis of MAGA is established by clinical examination. FDA has approved a combination of topical minoxidil and oral finasteride for MAGA treatment. Currently, there is another treatment option like dutasteride, a prostaglandin analog, ketoconazole, and co-adjuvant therapy like laser therapy, hair transplantation, and so on. Purpose: To provide an updated treatment for MAGA. Review: Etiopathogenesis of MAGA is influenced by genetic susceptibility and hormonal factors. The European Consensus Group set the evaluation diagnosis of MAGA to include a historyof hair fall, physical examination, hair examination, supporting examination, and clinical documentation. There are therapeutic options for MAGA, including antiandrogen therapies, androgen-independent therapies, and co-adjuvant therapies. The FDA has approved a combination of topical minoxidil and oral finasteride for MAGA treatment. MAGA may affect patients’ quality of life and self-esteem. In general, patients expect higher. Conclusion: MAGA is the most common progressive hair loss in males. The MAGA therapy is expected to achieve cosmetically significant regrowth and to slow additional hair loss.

A wide variety of leprosy clinical manifestations poses an early diagnostic challenge. Currently, various diagnostic modalities have been developed to optimize the definite diagnostic of leprae. Leprosy diagnosis was established based on the presence of either hypopigmented or reddish skin lesions accompanied with loss of sensation, peripheral nerve involvement, and a positive skin-slit smear (SSS) test result for acid-fast bacilli. Resemblance of leprosy skin lesions to excessively many other differential diagnoses, unclear nerve involvement, and negative results of SSS in paucibacillary (PB) leprosy become a diagnostic veil to clinicians. Furthermore, an additional modality for PB leprosy is needed as an important way to prevent misdiagnoses and complications of leprosy. Commonly, a biopsy or polymerase chain reaction examination is performed to exclude other similarly presenting diseases. Dermoscopy examination, the noninvasive technique that allows a better examination to visualize skin lesions, along with clinicopathology features of skin lesions can help to establish the diagnosis of PB leprosy.

Genital herpes is a recurrent, lifelong sexual transmitted infection caused by HSV, especially type 2. Genital herpes is the most common infection in HIV patient. HSV-2 can increase the risk of HIV acquisition 2 to 3 times. Clinical manifestations of genital herpes can be different between HIV- infected and non-HIV patients. HIV-infected patients have a high risk of developing chronic and severe genital ulcers with atypical manifestation, prolonged healing, and resistant to treatment, depends on CD4 count. Genital herpes can be diagnosed based on history, clinical manifestation, laboratory and histopathologic examination. Management of genital herpes includes education and counseling patients and sexual partners, systemic antiviral, and symptomatic treatment.

Tuberculoid granulomas consist of epithelioid histiocytes, Langhans giant cells and rarely foreign bodies with lymphocytes, plasma cells and caseous necrosis. The granulomatous reaction pattern is defined as a typical inflammatory pattern that is characterized by granulomas. Various etiologies can lead to granulomatous reactions. The histopathological features of cutaneous disorders with tuberculoid granuloma include cutaneous tuberculosis, tuberculids, Morbus Hansen, syphilis and rosacea. There are various clinical manifestations of tuberculoid granuloma with similar appearances which makes it difficult to establish a definitive diagnosis. The histopathological features of cutaneous tuberculoid granuloma disorders can support the diagnosis. Therefore, the clinician can determine the appropriate treatment with the right diagnosis.