Unusual Location of Syphilitic Alopecia

Pareek, Shiv Shanker

doi:10.1097/00007435-198201000-00010

Cited by 11 publications

(6 citation statements)

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“…SA is generally recognized as a great imitator owing to its various manifestations that mimic other hair disorders, such as alopecia areata, trichotillomania, tinea capitis, and telogen effluvium ( 3 ). It can manifest three clinical patterns that affect not only the scalp region, but also other hair-covered areas; these patterns include moth-eaten, diffuse, and mixed alopecia ( 4 ). In 1940, McCarthy described two types of SA based on the associated cutaneous presentations, and this classification continues to be used to date.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological, Clinical, and Trichoscopic Features of Syphilitic Alopecia: A Retrospective Analysis and Systematic Review

et al. 2022

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BackgroundSyphilitic alopecia (SA), which mimics other types of alopecia, is an uncommon manifestation of secondary syphilis. Trichoscopic features may facilitate its diagnosis. However, studies on SA and its trichoscopic characteristics remain limited.ObjectiveTo investigate the epidemiological, clinical, and trichoscopic findings and laboratory results, treatment, and outcomes of SA in Thai patients as well as to comprehensively summarize all trichoscopic features of SA through a systematic review.MethodsData on patients diagnosed with SA between December 2010 and December 2021 were obtained from their medical records and analyzed retrospectively. A systematic review of trichoscopic data, both from our institution and from studies registered in the PubMed, MEDLINE, and Embase databases, was conducted. A descriptive summarization was performed to comprehensively study the trichoscopic features of SA.ResultsOf the 205 patients with secondary syphilis, 23 patients with SA (symptomatic SA: 20, essential SA: 3) were included. The mean age was 27.6 ± 8.8 years, and male predominance was noted. The moth-eaten pattern was the most common SA presentation, and the parieto-occipital scalp was the most commonly affected area. All patients with SA achieved significant hair regrowth within 3 months of antibiotic therapy. Trichoscopic images were available for 20 patients with SA from our institute and were included in the systematic review. Fourteen articles provided information on 21 patients. Overall (N = 41), 26 (63.4%), 8 (19.5%), and 7 (17.1%) patients had moth-eaten alopecia, diffuse alopecia, and mixed alopecia, respectively. The most frequent trichoscopic finding was short regrowing hairs (78%), followed by decreased hair per follicular unit (75.6%), and empty follicles (51.2%). Unique features included flame hairs, bent tapering hairs, reddish-brown background, and brown rings around the perifollicular areas, each described in one case. However, the results were based only on case reports and small case series.ConclusionsGiven the progressively increasing frequency of SA, trichoscopic examination may be valuable when SA is suspected in patients with idiopathic alopecia; however, our findings are quite non-specific. The absence of exclamation mark hairs may help in the diagnosis of SA. Further comparative studies on other types of alopecia are required to determine the most useful diagnostic features.

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Section: Introductionmentioning

confidence: 99%

Epidemiological, Clinical, and Trichoscopic Features of Syphilitic Alopecia: A Retrospective Analysis and Systematic Review

et al. 2022

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“…SA most commonly affects the scalp, but can affect any region covered with hair such as eyebrows [5,6,7], eyelashes [6,7], beard, chest [8], legs [5], axillae [9], and the pubic area [9]. …”

Section: Introductionmentioning

confidence: 99%

Hair and Scalp Manifestations in Secondary Syphilis: Epidemiology, Clinical Features and Trichoscopy

et al. 2015

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Background: Syphilitic alopecia (SA) is mainly described in single case reports, and there are only a few epidemiological studies. Objective: To investigate the clinical and dermoscopic features of SA in patients with secondary syphilis and to record its actual prevalence. Methods: All patients with a diagnosis of secondary syphilis were clinically and trichoscopically evaluated in search of hair and scalp alterations. Results: Five of 12 patients (41.6%) diagnosed with secondary syphilis had SA. The ‘moth-eaten' pattern was detected in 4 patients (80% of cases): 1 had ‘essential' SA, whereas 3 patients had ‘symptomatic' SA. The ‘diffuse' SA pattern was found in 1 patient. Trichoscopy of the ‘moth-eaten' areas showed that alopecia is mainly due to a reduction in the number of terminal hairs. One patient with secondary syphilis showed trichodynia that regressed completely after antibiotic therapy. Limitations: The small number of patients included and the fact that none of our patients accepted to be biopsied in an affected area. Conclusion: Since SA appears to be present much more frequently than reported in the literature, when secondary syphilis is suspected, the patient should be examined for the presence of signs compatible with SA and the scalp should be examined by dermoscopy.

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“…Although the scalp is the most frequently affected area, other hairbearing sites such as the eyebrows, eyelashes, chest, axillae, pubis and legs can also be affected [11,[18][19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Primary and Secondary Syphilis Associated with Syphilitic Alopecia and Folliculitis in an HIV Positive Patient

Sousa¹

2013

Hair Therap Transplantat

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Syphilis has been classically divided into three clinical stages. The chancre that appears at the site of inoculation is referred to as the primary stage. The secondary stage is characterized by systemic involvement and the appearance of a disseminated maculopapular rash. Cardiovascular, neurologic and gummatous lesions characterize tertiary syphilis. The simultaneous presentation of primary and secondary syphilis has been reported because the chancre can persist into the secondary stage, especially in HIV positive patients. Although syphilitic alopecia is a rare manifestation of secondary syphilis it is an important differential diagnosis in the evaluation of patients with patchy hair loss. This article aims to present the case of a 34-year-old HIV-positive male patient that presented simultaneous primary and secondary syphilis associated with syphilitic alopecia and acute bacterial folliculitis.

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Unusual Location of Syphilitic Alopecia

Cited by 11 publications

References 0 publications

Epidemiological, Clinical, and Trichoscopic Features of Syphilitic Alopecia: A Retrospective Analysis and Systematic Review

Epidemiological, Clinical, and Trichoscopic Features of Syphilitic Alopecia: A Retrospective Analysis and Systematic Review

Hair and Scalp Manifestations in Secondary Syphilis: Epidemiology, Clinical Features and Trichoscopy

Simultaneous Primary and Secondary Syphilis Associated with Syphilitic Alopecia and Folliculitis in an HIV Positive Patient

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