Justified Suspicion: Symptomatic Syphilitic Alopecia in a Patient with Well-Controlled HIV

This case study described a 56-year-old male with well-controlled HIV who presented with symptoms including a rash, alopecia, and vision issues, leading to a diagnosis of syphilis. Despite having an undetectable viral load and a high CD4 count, the patient experienced syphilitic alopecia, highlighting the unpredictable nature of syphilis in HIV-positive individuals. The study emphasized the importance of maintaining a high index of suspicion for syphilis in such patients to prevent severe complications, as syphilis can present with varied and subtle symptoms, such as alopecia, even in those with well-managed HIV.