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Case of syphilis with alopecia and folliculitis as manifestations
Corresponding author: Dr. Wei Zhu, Department of Dermatology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. zhuwei@xwh.ccmu.edu.cn
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Received: ,
Accepted: ,
How to cite this article: Lin YY, Tseng YS, Zhu W. Case of syphilis with alopecia and folliculitis as manifestations. Indian J Dermatol Venereol Leprol 2021;87:125-6.
A 22-year-old homosexual man presented with increasing hair loss on the bitemporal scalp and scattered red follicular papules on his face over a period of 2 months. He claimed to have no previous history of genital ulcer or other skin lesions or application of medications/home remedies; however, dermatological examination revealed diffused red follicular papulopustules scattered on his face [Figure 1a]. The occipitotemporal scalp showed multiple irregular patches of nonscarring alopecia, with characteristic moth-eaten borders [Figure 1b]. Serological screening for syphilis further showed increased titers for rapid plasma reagin test (1:64), and Treponema pallidum hemagglutination assay and fluorescent treponemal antibody-absorption [Figure 2a] test were positive. serology for other sexually transmitted disorders were negative. Dermoscopy revealed black dots with diffuse telangiectasia in the alopecic patches, as well as brown rings around perifollicular areas [Figure 2b]. The patient denied biopsy on request. Alopecia is a rare clinical manifestation of secondary syphilis; however, with folliculitis it has seldom been mentioned in the literature.
- Diffuse red follicular pustules or papulopustules on the face
- Patches of irregular moth-eaten alopecia on the occipitotemporal scalp
- Fluorescent treponemal antibody-absorption test showed positive
- Dermatoscopy examination showed small patches of hair loss (blue arrow) with black dots (red arrow), brown rings around perifollicular areas (yellow arrow), and diffused telangiectasia (white arrow) (Dermoscopy-II, Dermat, China; polarized light mode, ×200)
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
