Syphilitic alopecia, a retrospective study




Jennifer A. Guerrero-Centeno, Servicio de Dermatología, Hospital Nacional Profesor Alejandro Posadas, Provincia de Buenos Aires, Buenos Aires, Argentina
Diego M. Loriente, Servicio de Dermatología, Hospital Nacional Profesor Alejandro Posadas, Provincia de Buenos Aires, Buenos Aires, Argentina
Roxana L. Di Gaeta, Servicio de Dermatología, Hospital Nacional Profesor Alejandro Posadas, Provincia de Buenos Aires, Buenos Aires, Argentina
Patricia S. Della-Giovanna, Servicio de Dermatología, Hospital Nacional Profesor Alejandro Posadas, Provincia de Buenos Aires, Buenos Aires, Argentina


Background: The incidence of syphilis is increasing, we must maintain a high degree of diagnostic suspicion for clinical findings such as alopecia. Syphilitic alopecia occurs in 4% of cases of secondary syphilis. We report 15 patients with syphilitic alopecia evaluated in our service in 2 years. Objective: To evaluate the relevance of alopecia as an important semiological finding for the diagnosis of syphilis. Method: Clinical records and photographic files of patients diagnosed with syphilis from September 1rst, 2016 and July 7th, 2018 were reviewed. For patients with syphilitic alopecia, the analyzed variables were: sex, age, reason for consultation, time of evolution, pattern, location, other dermatological manifestations, serological tests and evolution. Results: 153 patients were evaluated, 15 (9.8%) presented syphilitic alopecia (10 men and 5 women). The predominat age group was 20-30 years. Of 11 patients, alopecia was the main complaint; two consulted for other secondary syphilis injuries; and another two consulted for pathology not related to secondary syphilis. The most observed clinical form was the moth-eaten pattern (67%); the most frequently location was generalized (33%). All had positive results in VDRL or FTabs; one case had concomitant HIV infection. Fourteen patients (93%) completed treatment. Conclusions: We observe syphilitic alopecia in 9.8%. The most frequently observed pattern was moth-eaten alopecia and the most frequent distribution was widespread. It is important to know this clinical manifestation of secondary syphilis, which may be the key to early diagnosis of the disease.



Keywords: Syphilis. Alopecia. Syphilitic alopecia.