Differential diagnostics of syphilitic alopecia and alopecia areata: The clinical picture and trichoscopic signs

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Abstract


This paper describes a clinical case of secondary syphilis, which was manifested exclusively by syphilitic alopecia.

We describe the details of the clinical picture, as well as a differential diagnosis of syphilitic alopecia and alopecia areata on the basis of trichoscopy data.

For a patient with scalp lesions typical of syphilis (focal form of alopecia), the trichoscopic picture was represented by hairs broken at different heights from 1 to 5 mm, “empty” follicles (“yellow” dots), anisotrichosis due to the loss of terminal hair. The eyebrow trichoscopy showed “yellow dots”, vellus hairs, hair thinning due to the loss of bristly hair. A comparison of the trichoscopic pictures for alopecia areata and syphilitic areata have revealed the absence in the latter of a number of signs typical of the former, such as pencil-point, ex clamation-point, zigzag, monilethrix and tulip hairs.

Patients with a clinical picture of focal, diffuse or mix ed alopecia should be tested for syphilis using serological methods.


About the authors

A. N. Mareeva

State Research Center of Dermatovenereology and Cosmetology, Ministr y of Health of the Russian Federation

Author for correspondence.
Email: nastasya_66@mail.ru

Russian Federation

Anastasia N. Mareeva* — Cand. Sci. (Med.), Dermatovenerologist, Consultative Diagnostic Centre

tel.: +7 (903) 586-27-79

G. L. Katunin

State Research Center of Dermatovenereology and Cosmetology, Ministr y of Health of the Russian Federation

Email: fake@neicon.ru

Russian Federation Georgy L. Katunin — Cand. Sci. (Med.), Dermatovenerologist, Department of Sexually Transmitted Infections

A. B. Rubtsov

State Research Center of Dermatovenereology and Cosmetology, Ministr y of Health of the Russian Federation

Email: fake@neicon.ru

Russian Federation Anton B. Rubtsov — Research Assistant, Department of Sexually Transmitted Infections

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