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Distinct clinical, dermatoscopic and histopathological features were found in SLE-associated alopecia regions, which were different from those of AA. Serological autoantibody tests are of value to confirm the differential diagnosis. Local angiotelectasis and vasculitis close to hair follicles may be involved in the pathogenesis of alopecia in SLE.

Background: Syphilitic alopecia is not common in patients with secondary syphilis. Though the clinical and histopathological findings of syphilitic alopecia have been described, the trichoscopy features are unknown yet. Main observation:A 42-year-old Chinese man was admitted to our clinic with a complaint of hair loss. The patient presented clinically with moth-eaten alopecia over the whole scalp without any previous discomfort or skin rashes. The serology for syphilis was positive. Trichoscopy showed black dots, focal atrichia, hypopigmentation of hair shaft and yellow dots. Conclusions:On the basis of trichoscopy, along with serology testing syphilitic alopecia can be differentiated from other hair loss diseases with similar clinical presentation. (J Dermatol Case Rep. 2014; 8(3): 78-80) The clinical and trichoscopic features of syphilitic alopecia Yanting Ye, Xiaoting Zhang, Ying Zhao, Yugang Gong, Jian Yang, Huan Li, Xingqi Zhang Department of Dermatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, People's Republic of China. IntroductionSyphilis as a "great mimic" can present various manifestations indistinguishable from other diseases. Syphilitic alopecia is an uncommon clinical manifestation of secondary syphilis with an incidence of 2.9%-11.2%. 1,2The clinical manifestations and histopathological features of syphilitic alopecia have been described in detail, but the trichoscopic features of syphilitic alopecia have not been described yet. Here we present a case of syphilitic alopecia, and describe the clinical and trichoscopic features. Case reportA 42-year-old Chinese man came to our clinic with a complaint of hair loss for 2 weeks, without scalp pruritus or pain. He also complained about being under high mental stress recently. He was heterosexual and was engaging in casual sex. He denied having any skin lesions in the genital area before the hair loss, i.e., the clinical manifestations of primary syphilis. The patient had a past history of asthma and diabetes mellitus, but no history of hair loss.On physical examination of the scalp area, numerous small scattered non-scarring hairless patches with incomplete hair loss were observed. The patches were irregular in size without defined borders, ranged from 0.2cm-0.5cm in diameter, distributed over the whole scalp giving the appearance of moth-eaten alopecia (Fig. 1). The hairless areas showed no signs of inflammation or desquamation. The gentle pull test was negative. Under trichoscopy black dots, focal atrichia, hypopigmentation of hair shafts and yellow dots were observed (Fig. 2). The empty ostia of hair follicle were presented. No skin rash was found all over the body. Up till now, the primary clinical impressions include syphilitic alopecia (SA) and alopecia areata (AA).Blood tests were performed including blood count, total IgE, antinuclear autoantibodies tests, serology for HIV and syphilis. The results of serology for syphilis were positive: rapid plasma reagin test (RPR) with titer of 1:64...