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Indian J Sex Transm Dis AIDSIndian J Sex Transm Dis AIDSIJSTDIndian Journal of Sexually Transmitted Diseases and AIDS2589-05572589-0565Medknow Publications & Media Pvt Ltd India IJSTD-38-19210.4103/ijstd.IJSTD_92_16PhotofeatureAlopecia syphilitica Chiu Hsiu-Hui 1Wu Chieh-Shan 231 Department of Dermatology, Pingtung Christian Hospital, Pingtung, Taiwan2 Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan3 Department of Dermatology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanAddress for correspondence: Dr. Chieh-Shan Wu, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City 81362, Taiwan. E-mail: dermawu@vghks.gov.twJul-Dec 2017 38 2 192 193 Copyright: © 2017 Indian Journal of Sexually Transmitted Diseases and AIDS2017This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.Alopecia syphilitica is a less common manifestation of secondary syphilis. It could present with other mucocutaneous symptoms of secondary syphilis or rarely present as the only symptom of secondary syphilis, the so-called “essential syphilitic alopecia.” Herein, we present a case of essential syphilitic alopecia to remind physicians, especially for sexually active patients.

Key words
Alopeciaalopecia syphiliticasecondary syphilis
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A 33-year-old male presented with hair loss for about 6 weeks. On physical examination, the skin of scalp is normal. Diffuse thinning of the hair on the right temporal scalp [Figure 1] and several small, patches of hair loss, compatible with “moth-eaten” alopecia, on the left temporal scalp [Figure 2] were noted. Laboratory evaluation revealed increased titers for rapid plasma reagin (RPR) test of 1:128 and Treponema pallidum particle agglutination assay test of >1:20480. The diagnosis of alopecia syphilitica was made and he was treated with single intramuscular injections of benzathine penicillin (2.4 million units). Two months later, RPR test decreased to 1:8 and alopecia improved. Alopecia syphilitica is a less common manifestation of secondary syphilis. It could present with other mucocutaneous symptoms of secondary syphilis or rarely present as the only symptom of secondary syphilis, the so-called “essential syphilitic alopecia.” The latter is easily misdiagnosed. Physicians should keep the diagnosis of alopecia syphilitica in mind, especially in a sexually active patient.

Figure 1 Diffuse thinning of the hair on the right temporal scalp

Figure 2 Several small, patches of hair loss, compatible with “moth-eaten” alopecia, on the left temporal scalp

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