Syphilitic alopecia: uncommon trichoscopic findings

Area of Science:

• Dermatology
• Infectious Diseases
• Trichology

Background:

• Syphilitic alopecia (SA) is an uncommon manifestation of secondary syphilis.
• SA presents as diffuse (mimicking telogen effluvium) or moth-eaten patterns, or a mixed form.
• Essential SA lacks mucocutaneous signs, delaying diagnosis.

Purpose of the Study:

• To report the first case of a mixed pattern of essential syphilitic alopecia.
• To describe novel trichoscopic features associated with this mixed pattern.
• To emphasize dermoscopy's role in diagnosing SA when other signs are absent.

Main Methods:

• Case report of a 32-year-old male with essential syphilitic alopecia.
• Detailed trichoscopic examination of the scalp.
• Clinical correlation and differential diagnosis.

Main Results:

• The patient presented with a mixed pattern of essential syphilitic alopecia.
• New trichoscopic findings included tapered bended hairs, erythematous background, diffuse scaling, and perifollicular hyperkeratosis.
• These features aided in differentiating SA from other alopecias.

Conclusions:

• The mixed pattern of essential syphilitic alopecia is rare and presents unique trichoscopic findings.
• Trichoscopy, particularly dermoscopy, is a valuable tool for diagnosing SA, especially when mucocutaneous manifestations are absent.
• Early recognition and diagnosis of SA are crucial for effective treatment and preventing complications.