Alopecia as the Presenting Symptom of Syphilis

In 2015, a case study was presented of a 50-year-old man who had alopecia as the sole presenting symptom of syphilis. Despite an initial negative rapid plasma reagin (RPR) test, a scalp biopsy revealed the presence of Treponema pallidum, the bacterium that causes syphilis. The patient's hair loss improved after treatment with benzathine penicillin. This case highlighted the need for clinicians to consider syphilis as a potential cause of alopecia, even if other symptoms of the disease are not present. The patient had no other manifestations of secondary syphilis, making this a case of essential syphilitic alopecia.