Tomohisa Fukui^1,2*, Yusuke Sakuraba¹, Ken Harada², Hajime Nakano¹, Daisuke Sawamura¹

Show more
¹ Department of Dermatology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
² Department of Dermatology, Aomori Central Hospital, Aomori, Japan.
Show less

Abstract: Syphilitic alopecia (SA) is a rare skin manifestation in secondary syphilis and sometimes indistinguishable from other alopecia. SA is of 2 types, symptomatic and essential, and 3 clinical types, moth-eaten or patchy pattern, diffuse pattern and a combination of both. SA in our case indicated symptomatic SA with moth-eaten hairloss. A 46-year-old Japanese homosexual man experienced hairloss followed by the pruritic skin rash. Physical examination of the scalp showed diffusely spread papulosquamous erythema and incomplete hairloss around the lesions. The scalp lesions appeared as “moth-eaten alopecia”. Serological examination for syphilis and HIV were positive. Thus, SA complicated with HIV infection was diagnosed. He was treated with a single perioral dose of ampicillin for 4 weeks, then his condition improved rapidly and hair regrowth occurred. HIV-infected persons show a high incidence of syphilis. Therefore, HIV test should be considered for patients with alopecia.

Keywords: Alopecia, Syphilis, Syphilitic Alopecia, Moth-Eaten Alopecia, HIV

Cite this paper: Fukui, T. , Sakuraba, Y. , Harada, K. , Nakano, H. and Sawamura, D. (2016) Moth-Eaten Symptomatic Syphilitic Alopecia Associated with Human Immunodeficiency Virus—A Case Report. Case Reports in Clinical Medicine, 5, 188-190. doi: 10.4236/crcm.2016.55035.

References

[1]   Vafaie, J., Weinberg, J.M., Smith, B. and Mizuguchi, R.S. (2005) Alopecia in Association with Sexually Transmitted Disease: A Review. Cutis, 76, 361-366.

[2]   Hira, S.K., Patel, J.S., Bhat, S.G., Chilikima, K. and Mooney, N. (1987) Clinical Manifestations of Secondary Syphilis. International Journal of Dermatology, 26, 103-107.
http://dx.doi.org/10.1111/j.1365-4362.1987.tb00532.x

[3]   Hernández-Bel, P., Unamuno, B., Sánchez-Carazo, J.L., Febrer, I. and Alegre, V. (2013) Syphilitic Alopecia: A Report of 5 Cases and a Review of the Literature. Actas Dermo-Sifiliográficas, 104, 512-517.
http://dx.doi.org/10.1016/j.ad.2012.02.009

[4]   Bi, M.Y., Cohen, P.R., Robinson, F.W. and Gray, J.M. (2009) Alopecia Syphilitica Report of a Patient with Secondary Syphilis Presenting as Moth-Eaten Alopecia and a Review of Its Common Mimickers. Dermatology Online Journal, 15, 6.

[5]   Cuozzo, D.W., Benson, P.M., Sperling, L.C. and Skelton, H.G. (1995) Essential Syphilitic Alopecia Revisited. Journal of the American Academy of Dermatology, 32, 840-843.
http://dx.doi.org/10.1016/0190-9622(95)91543-5

[6]   Chesson, H.W., Heffelfinger, J.D., Voigt, R.F. and Collins, D. (2005) Estimates of Primary and Secondary Syphilis Rates in Persons with HIV in the United States, 2002. Sexually Transmitted Diseases, 32, 265-269.
http://dx.doi.org/10.1097/01.olq.0000162359.75509.9c