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Syphilitic Alopecia


Presentation

  • We present 5 cases of this uncommon manifestation and review the corresponding literature. All of the patients in our series were men aged between 31 and 46 years.[ncbi.nlm.nih.gov]
  • Patients often present with other mucocutaneous symptoms of secondary syphilis.[escholarship.org]
  • It is non-inflammatory and non-cicatricial hair loss that can present in a diffuse pattern, a moth-eaten pattern, or a combination of both.[ncbi.nlm.nih.gov]
  • Confluent small alopecic patches of the parietal area are present on an erythematous scalp (a) .[derm101.com]
  • The past, present, and future of CEP are recapitulated.[medworm.com]
Prostitute
  • It was a frank and unsettling depiction of the taboos of that time, of sex and sexually transmitted diseases, of infidelity and prostitution.” Pyromania![blogs.discovermagazine.com]
Drooling
  • The doctor warned of minor side effects: uncontrolled drooling, fetid breath, bloody gums, shakes and palsies. Yet desperate diseases called for desperate remedies, of course.[books.google.com]
Alopecia
  • We describe two patients with syphilis in whom the first sign of disease was alopecia and discuss the clinical and histopathologic findings of essential syphilitic alopecia.[ncbi.nlm.nih.gov]
  • A case of syphilitic alopecia on the legs of young man is described. Both positive serologic tests and the clinical response to treatment with penicillin suggest that this alopecia was due to syphilis.[ncbi.nlm.nih.gov]
  • The lesions, which were located mainly in the parieto-occipital area of the scalp, manifested as multiple, irregular, nonscarring patches of alopecia that adopted a characteristic patchy moth-eaten pattern.[ncbi.nlm.nih.gov]
  • Syphilitic alopecia can closely resemble alopecia areata both clinically and histopathologically.[academic.oup.com]
  • Conditions that mimic moth-eaten alopecia include other localized and non-cicatricial alopecias, such as alopecia areata, alopecia neoplastica, tinea capitis, and trichotillomania.[escholarship.org]
Hyperkeratosis
  • Moreover, we observed additional features, including tapering hairs, diffuse scaling and focal follicular hyperkeratosis.[derm101.com]
  • Discoid and disseminated lupus erythematosus on the skin and scalp is manifested by a triad of symptoms: erythema, hyperkeratosis and cicatricial atrophy.[en.medicine-guidebook.com]
Follicular Hyperkeratosis
  • Moreover, we observed additional features, including tapering hairs, diffuse scaling and focal follicular hyperkeratosis.[derm101.com]
Painless Penile Lesion
  • 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![mshc.org.au]
Forgetful
  • […] 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[mshc.org.au]

Workup

Microsporum
  • In North America, Trichophyton tonsurans and Microsporum canis are responsible for the majority of the cases [ 18 ]. This infection is commonly seen in African American children under the age of 12 [ 19 ].[escholarship.org]
Trichophyton Tonsurans
  • In North America, Trichophyton tonsurans and Microsporum canis are responsible for the majority of the cases [ 18 ]. This infection is commonly seen in African American children under the age of 12 [ 19 ].[escholarship.org]

Treatment

  • Both positive serologic tests and the clinical response to treatment with penicillin suggest that this alopecia was due to syphilis.[ncbi.nlm.nih.gov]
  • Natural 500ML Herbal Hair Shampoo Black Rose Moisturizing Hair Treatment Cream HMG-18.[hieratic.eu]
  • The hair loss usually resolves within 3 months of treatment.[ncbi.nlm.nih.gov]
  • The lesions improved with treatment in all the patients who attended follow-up. Dermatologists should maintain a high level of clinical suspicion for this uncommon manifestation of syphilis, particularly when it is the only symptom.[ncbi.nlm.nih.gov]
  • Treatment The preparation, dosage, and duration of treatment vary, depending on the stage of syphilis, HIV status of the patient, and presence of neurosyphilis [ 23, 24, 25, 26 ].[escholarship.org]

Prognosis

  • […] favorable prognosis for patients diagnosed with either primary or secondary syphilis 20% of untreated patients with tertiary syphilis die of the disease prognosis for tertiary syphilis depends on the extent of scarring and tissue damage with adequate[medbullets.com]
  • Patient Education National Alopecia Areata Foundation: www.naaf.org Prognosis Androgenic alopecia : Prognosis depends on response to treatment. AA : often regrows within 1 year even without treatment.[unboundmedicine.com]
  • With penicillin administration, hair of the legs, scalp, and eyebrows started to grow; the hair was fully regrown within 6 months, which suggests good prognosis with treatment instigation for syphilitic alopecia of all areas.[mdedge.com]
  • The more profuse the eruption the better is the prognosis. The severe type (Oroya): The only skin manifestations are mild skin lesion due to insect bite at the site of inoculation.[drmhijazy.com]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • McKee's Pathology of the Skin is the most complete, in-depth resource on dermatopathology, covering etiology, pathogenesis, disease mechanisms, and recent genetic, molecular, and basic science data. Drs. J.[books.google.com]
  • Clinically, diffuse syphilitic alopecia, as a rule, does not differ from symptomatic hair loss of a different etiology, therefore, in all patients with a sudden diffuse alopecia of unknown etiology, it is recommended to investigate serological responses[en.medicine-guidebook.com]
  • Treatments all focus on symptom management rather than etiology.[unboundmedicine.com]
  • Etiology Treponema bacteria (particularly during stages I/II) are highly contagious! Sexual contact with a partner who suffers from active syphilis will lead to infection in 30% of cases![amboss.com]

Epidemiology

  • Venereal Diseases; Milica Marković ; City Institute for Skin and Venereal Diseases Džordža Vašingtona 17 11000 Belgrade Serbia Dubravka Salemović ; Institute for Infectious and Tropical Diseases, Clinical Centre of Serbia Sandra Šipetić ; Institute of Epidemiology[hrcak.srce.hr]
  • Reexamining syphilis: an update on epidemiology, clinical manifestations, and management. Annals of Pharmacotherapy 2008; 42: 226-236. [ PubMed ] 13. Jordaan HF, Louw M.[escholarship.org]
  • Piraccini BM, Broccoli A, Starace M, Jasper V, D'Antuono A, Dika A, Patrizi A: Hair and scalp manifestations in secondary syphilis: epidemiology, clinical features and trichoscopy. Dermatology 2015;231:171-176.[karger.com]
  • Epidemiology References: [1] [2] Epidemiological data refers to the US, unless otherwise specified. Etiology Treponema bacteria (particularly during stages I/II) are highly contagious![amboss.com]
  • Hair and scalp manifestations in secondary. syphilis: epidemiology, clinical features and trichoscopy. Dermatology. 2015;231(2):171-176. PubMed CrossRef 6. Jordaan HF, Louw M. The moth-eaten alopecia of secondary syphilis.[derm101.com]
Sex distribution
Age distribution

Pathophysiology

  • References: [3] [4] Pathophysiology Clinical features Primary syphilis Primary lesion ( chancre ) Typically starts out as a solitary, raised papule (usually on the genitals) Evolves into painle ss, firm ulcer with indurated borde rs and smooth base Resolves[amboss.com]
  • Commonly Associated Conditions See “Etiology and Pathophysiology.”[unboundmedicine.com]

Prevention

  • Encyclopedia) RPR test (Medical Encyclopedia) Syphilis (Centers for Disease Control and Prevention) Syphilis - primary (Medical Encyclopedia) Syphilis and MSM (Men Who Have Sex with Men) (Centers for Disease Control and Prevention) VDRL test (Medical[icdlist.com]
  • Chapter 69 Surrogate Markers of Antiretroviral Efficacy 826 Overcoming Barriers to Providing ARV Therapy in ResourceLimited Settings 831 Chapter 71 Antiretroviral Drugs for HIV Prevention 836 Chapter 72 Acute HIV Infection 843 Chapter 73 Opportunistic[books.google.com]
  • It is unclear, however, whether repeated doses or larger doses of benzathine penicillin would prevent neurosyphilis [ 25 ].[escholarship.org]
  • Lard as an ointment base is frequently used, with the addition of about five per cent, of benzoin to prevent rancidity.[books.google.com]
  • (NIH/National Institute of Allergy and Infectious Diseases) The National Institute of Allergy and Infectious Diseases (NIAID) today announced awards to establish four Cooperative Research Centers (CRCs) focused on developing vaccines to prevent sexually[medworm.com]

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