Syphilitic Alopecia

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HISTORY

  • 24 year old bisexual man
  • 6 weeks previously had unprotected oral sex with male
  • Subsequently told that this man had syphilis
  • In the 2 weeks before presenting, he noticed a painless penile lesion and was losing his hair!

 

EXAMINATION

 

INVESTIGATIONS:

Dark-ground examination: negative

Tr pallidum PCR positive

RPR: 256

 

 

CLINICAL PROGRESS

  • Treated with a single IM dose of benzathine penicillin
  • Reviewed a week later, when he reported myalgia following the penicillin dose, improvement in his hair loss and rapid healing of the penile lesion:

 

DIAGNOSIS:

Secondary syphilis, presenting with alopecia and a penile mucous patch

Links to other case reports of alopecia in syphilis:

Psychological impact of alopecia

Don’t forget syphilis www.bmj.com/cgi/content/full/331/7524/1084-b


Dated November, 2007