Essential Syphilitic Alopecia: Non-Scarring Alopecia in a 21-Year-Old Man

In 2021, a case study was conducted on a 21-year-old man from Belgium who presented with non-scarring alopecia, or hair loss, which was later diagnosed as alopecia syphilitica, a less common manifestation of secondary syphilis. The patient had no previous history of genital or other skin lesions and his hair loss was the only symptom. Laboratory tests confirmed the presence of syphilis and he was treated with a single intramuscular injection of benzathine penicillin, which led to an improvement in his condition. The study highlighted the importance of maintaining a high level of clinical suspicion for syphilis, particularly when hair loss is the only symptom. The researchers also noted that alopecia syphilitica can present in three distinct clinical patterns: moth-eaten or patchy, diffuse, and mixed. The pathogenesis of alopecia syphilitica remains unclear due to inconsistent findings of spirochetes in hair follicles.