Epidemiological, Clinical, and Trichoscopic Features of Syphilitic Alopecia: A Retrospective Analysis and Systematic Review

The study analyzed 194 patients diagnosed with secondary syphilis, finding that 11.2% of them exhibited Syphilitic Alopecia (SA), a rare manifestation of the disease. The most common clinical presentation of SA was the moth-eaten pattern (56.5%), followed by the mixed pattern (26.1%) and diffuse alopecia (17.4%). Trichoscopic images showed common presentations of empty follicles, short regrowing hairs, decreased hair per follicular unit, and an erythematous background. All patients with SA experienced significant hair regrowth within 6 months after therapy. The study also reviewed 14 other studies, pooling data to find that moth-eaten alopecia was the most common pattern (63.4%). The study concluded that early recognition of SA and its trichoscopic findings could facilitate early diagnosis and treatment, improving outcomes. However, further studies with larger sample sizes are recommended.