Syphilitic Alopecia: A Rare Manifestation of Secondary Syphilis
April 2012
in “
Informa Healthcare eBooks
”
syphilitic alopecia secondary syphilis alopecia areata catagen follicles telogen follicles peribulbar mononuclear cell infiltrate plasma cells lymphocytic infiltration outer root sheath serologic tests antitreponemal antibiotics immunohistochemical stains spirochetal antigens AA blood tests antibiotics immunostains
TLDR Syphilitic alopecia is a rare hair loss condition in secondary syphilis that looks similar to another condition but can be diagnosed with specific tests and responds to antibiotics.
Syphilitic alopecia is a rare manifestation of secondary syphilis, affecting only 4% of patients. It can present with various clinical patterns, including patchy, diffuse, or a combination of both, and may be the sole external sign of syphilis. Histologically, syphilitic alopecia can mimic alopecia areata (AA) with increased numbers of catagen/telogen follicles and a peribulbar mononuclear cell infiltrate. However, syphilitic alopecia differs from AA by the presence of plasma cells and lymphocytic infiltration of the outer root sheath. Serologic tests for syphilis and a positive response to antitreponemal antibiotics are diagnostic. Immunohistochemical stains for spirochetal antigens can also confirm the presence of the organism. The document emphasizes the need for a high index of suspicion to diagnose syphilitic alopecia due to its rarity and similarity to AA.
