Syphilitic Alopecia: Report of a Challenging Case and Review of the Literature

In 2020, a case study was conducted on a 61-year-old man who presented with syphilitic alopecia and neurosyphilis, a rare simultaneous occurrence. Syphilitic alopecia, a rare manifestation of syphilis, usually occurs in 2.9-11.2% of infected patients. The patient had been experiencing multiple non-specific symptoms for ten years before being diagnosed. His symptoms included hair loss, pruritic eruption in the face, generalized arthralgia, asthenia, myalgia, headache, tinnitus, and decreased vision. After a series of tests, he was diagnosed with secondary syphilis and neurosyphilis. He was treated with penicillin G sodium 24,000,000 IU/day intravenously for 10 days. After seven days, his ocular symptoms improved, and after three months, his facial lesions disappeared and the alopecia completely resolved. The patient remained asymptomatic with normal fundus and serum VDRL values of 2 dils over a period of six years of follow-up. This case emphasizes the importance of recognizing the cutaneous manifestations of syphilis, as the final diagnosis was reached through the patient's alopecia.