Alopecia syphilitica, a simulator of alopecia areata: histopathology and differential diagnosis

Lee, J. Yu-Yun; Hsu, M.m‐L.

doi:10.1111/j.1600-0560.1991.tb00133.x

Cited by 61 publications

(42 citation statements)

References 8 publications

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“…All patients had prominent and characteristic multifocal irregular areas of patchy scarring hair loss resembling moth eaten alopecia which is similar to what has been seen in secondary syphilis and alopecia areata [11,12] ( Figures 3 and 4).…”

Section: Discussionsupporting

confidence: 70%

“…All patients had prominent and characteristic multi- focal irregular areas of patchy scarring hair loss resembling moth eaten alopecia which is similar to what has been seen in secondary syphilis and alopecia areata [12,13] (Figures 3 and 4). However loss of follicular orifices can readily discriminate the scarring moth eaten alopecia of LPP from that of non scarring moth eaten alopecia of secondary syphilis or alopecia areata [13].…”

Section: Discussionsupporting

confidence: 64%

“…However, loss of follicular orifices can readily discriminate the scarring moth eaten alopecia of LPP from that of non scarring moth eaten alopecia in secondary syphilis or alopecia areata [12]. This observation was not well documented in the medical literature.…”

Section: Discussionmentioning

confidence: 93%

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Lichen Planopilaris is a Common Scarring Alopecia among Iraqi Population

Sharquie¹,

Noaimi²,

Hameed³

2013

JCDSA

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Background: Scarring alopecia like discoid lupus erythematosus, lichenplanopilaris and scarring folliculitis are common skin problems where differentiations between them are often difficult in many cases. Objective: To report, study and evaluate cases of lichen planopilaris and characterize the different clinical points in favor of this disease. Patients and Methods: This case series descriptive study was done at Department of Dermatology-Baghdad Teaching Hospital from January 2010 to November 2012. Sixty seven patients were included where histological and dermatological examinations were carried out to all patients regarding all relevant points related to the disease. Punch biopsies were performed from ten patients for histopathological study. Results: The mean age of onset of the disease was 36.7 ± 5 years with a mean duration of the disease being 4.4 ± 3 years. The male to female ratio was 1.4:1. The characteristic lesions were pigmented scarring moth eaten alopecia surrounded by pigmented hyperkeratotic follicular papules involving mainly the fronto-vertical and parietal scalp. Conclusions: Lichen planopilaris is a common cause of scalp scarring alopecia in adult and it has many characteristic clinical features which can facilitate differentiation from other pathologic scalp conditions like discoid lupus erythematosus.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionsupporting

confidence: 64%

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Lichen Planopilaris is a Common Scarring Alopecia among Iraqi Population

Sharquie¹,

Noaimi²,

Hameed³

2013

JCDSA

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“…The histopathology findings of SA usually include a normal epidermis with areas of follicular hyperkeratosis, a marked reduced number of anagen follicles and an increasing number of catagen and telogen follicles. 3,10 A presence of a perivascular by serological tests, with intramuscular injection of benzathine benzylpenicillin, a weekly dose of 2.4 million unit for 3 weeks. Regrowth of hair was observed 12 weeks after the start of the treatment.…”

Section: Case Reportmentioning

confidence: 99%

The clinical and trichoscopic features of syphilitic alopecia

Ye¹,

Zhang²,

Zhang³

et al. 2014

J Dermatol Case Rep

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Background: Syphilitic alopecia is not common in patients with secondary syphilis. Though the clinical and histopathological findings of syphilitic alopecia have been described, the trichoscopy features are unknown yet. Main observation:A 42-year-old Chinese man was admitted to our clinic with a complaint of hair loss. The patient presented clinically with moth-eaten alopecia over the whole scalp without any previous discomfort or skin rashes. The serology for syphilis was positive. Trichoscopy showed black dots, focal atrichia, hypopigmentation of hair shaft and yellow dots. Conclusions:On the basis of trichoscopy, along with serology testing syphilitic alopecia can be differentiated from other hair loss diseases with similar clinical presentation. (J Dermatol Case Rep. 2014; 8(3): 78-80) The clinical and trichoscopic features of syphilitic alopecia Yanting Ye, Xiaoting Zhang, Ying Zhao, Yugang Gong, Jian Yang, Huan Li, Xingqi Zhang Department of Dermatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, People's Republic of China. IntroductionSyphilis as a "great mimic" can present various manifestations indistinguishable from other diseases. Syphilitic alopecia is an uncommon clinical manifestation of secondary syphilis with an incidence of 2.9%-11.2%. 1,2The clinical manifestations and histopathological features of syphilitic alopecia have been described in detail, but the trichoscopic features of syphilitic alopecia have not been described yet. Here we present a case of syphilitic alopecia, and describe the clinical and trichoscopic features. Case reportA 42-year-old Chinese man came to our clinic with a complaint of hair loss for 2 weeks, without scalp pruritus or pain. He also complained about being under high mental stress recently. He was heterosexual and was engaging in casual sex. He denied having any skin lesions in the genital area before the hair loss, i.e., the clinical manifestations of primary syphilis. The patient had a past history of asthma and diabetes mellitus, but no history of hair loss.On physical examination of the scalp area, numerous small scattered non-scarring hairless patches with incomplete hair loss were observed. The patches were irregular in size without defined borders, ranged from 0.2cm-0.5cm in diameter, distributed over the whole scalp giving the appearance of moth-eaten alopecia (Fig. 1). The hairless areas showed no signs of inflammation or desquamation. The gentle pull test was negative. Under trichoscopy black dots, focal atrichia, hypopigmentation of hair shafts and yellow dots were observed (Fig. 2). The empty ostia of hair follicle were presented. No skin rash was found all over the body. Up till now, the primary clinical impressions include syphilitic alopecia (SA) and alopecia areata (AA).Blood tests were performed including blood count, total IgE, antinuclear autoantibodies tests, serology for HIV and syphilis. The results of serology for syphilis were positive: rapid plasma reagin test (RPR) with titer of 1:64...

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“…It can be the only clinical symptom of syphilis infection and mimic alopecia areata in clinical course or on histopathological findings [3]. Syphilitic hair loss, suggested to be caused by the direct infection of hair follicles by Treponema pallidum [4], is non-inflammatory and noncicatricial and typically presents in a diffuse or in a moth-eaten pattern with multiple patches of non-scarring alopecia, or in a combination of both [5,6].…”

mentioning

confidence: 99%