Case report
Essential syphilitic alopecia revisited

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Abstract

There has been a resurgence of syphilis in the past decade. Uncommonly, diffuse hair loss, termed essential alopecia, is the only sign of syphilitic infection. We describe two patients with syphilis in whom the first sign of disease was alopecia and discuss the clinical and histopathologic findings of essential syphilitic alopecia.

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Cited by (45)

  • Syphilitic alopecia: A report of 5 cases and a review of the literature

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    It is important to initiate early treatment to avoid possible late complications, as the association between alopecia and cerebrospinal neurosyphilis has traditionally been assumed.4,5 SA may sometimes be the only manifestation of secondary syphilis,5,6 as in our case 4, and it is therefore important to maintain a high level of diagnostic suspicion in order to avoid a late or incorrect diagnosis. In patients with other skin manifestations, systematic examination of the scalp and other areas of hairy skin could reveal that SA is more common than is described in the literature and that it is underdiagnosed at the present time.

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    Tertiary syphilis may also cause madarosis.78 Lumbar puncture may be indicated given the incidence of concomitant neurosyphilis.26,142 Leprosy (Hansen disease) usually affects the outer third of the eyebrow, with madarosis noted most often in patients with lepromatous disease of long duration and higher patient age.28,78,127,142

  • Spirochetal infections

    2009, Weedon's Skin Pathology: Third Edition
  • Moth-eaten alopecia: A sign of secondary syphilis

    2013, CMAJ. Canadian Medical Association Journal
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