Mixed-pattern, essential syphilitic alopecia, uveitis, and papillitis in an immunocompetent patient with neurosyphilis

Syphilitic alopecia (SA) and ocular syphilis (OS) are rare manifestations of syphilis, typically reported together in immunocompromised patients. We present a unique case of mixed-pattern, essential, SA of the scalp and OS in the form of anterior uveitis in an otherwise immunocompetent, HIV-negativ...

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Main Authors: Sumeetha Swaminathan, Irina Lerman, Kathleen Mannava, Luca Zatreanu, Anna De Benedetto
Format: Article
Language:English
Published: PAGEPress Publications 2025-07-01
Series:Dermatology Reports
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Online Access:https://www.pagepress.org/journals/dr/article/view/10371
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author Sumeetha Swaminathan
Irina Lerman
Kathleen Mannava
Luca Zatreanu
Anna De Benedetto
author_facet Sumeetha Swaminathan
Irina Lerman
Kathleen Mannava
Luca Zatreanu
Anna De Benedetto
author_sort Sumeetha Swaminathan
collection DOAJ
description Syphilitic alopecia (SA) and ocular syphilis (OS) are rare manifestations of syphilis, typically reported together in immunocompromised patients. We present a unique case of mixed-pattern, essential, SA of the scalp and OS in the form of anterior uveitis in an otherwise immunocompetent, HIV-negative, 46-year-old female. Briefly, the patient initially presented with sudden-onset scalp hair loss that was initially diagnosed as atypical alopecia areata but failed to respond to typical alopecia areata-directed therapy. Concurrently, the patient developed ocular and neurologic symptoms, and the diagnosis of syphilis was rendered based on the constellation of clinical findings and cerebrospinal fluid/serologic testing. Syphilis-directed therapy resulted in the reversal of ocular and neurologic symptoms, as well as rapid scalp hair regrowth. This case highlights the importance of considering diagnosis of syphilis in the differential diagnosis for atypical alopecia.
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publishDate 2025-07-01
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series Dermatology Reports
spelling doaj-art-9dd9ab99ab4f46bcae89e76bf7f87c282025-08-20T02:50:27ZengPAGEPress PublicationsDermatology Reports2036-73922036-74062025-07-0110.4081/dr.2025.10371Mixed-pattern, essential syphilitic alopecia, uveitis, and papillitis in an immunocompetent patient with neurosyphilisSumeetha Swaminathan0https://orcid.org/0009-0006-5817-1744Irina Lerman1https://orcid.org/0000-0003-1410-7856Kathleen Mannava2Luca Zatreanu3Anna De Benedetto4https://orcid.org/0000-0001-6293-435XDepartment of Dermatology, University of Rochester Medical Center, Rochester (NY)Department of Dermatology, University of Rochester Medical Center, Rochester (NY); Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester (NY)Department of Dermatology, University of Rochester Medical Center, Rochester (NY); Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester (NY)Department of Ophthalmology, Rochester Regional Health, Rochester (NY)Department of Dermatology, University of Rochester Medical Center, Rochester (NY) Syphilitic alopecia (SA) and ocular syphilis (OS) are rare manifestations of syphilis, typically reported together in immunocompromised patients. We present a unique case of mixed-pattern, essential, SA of the scalp and OS in the form of anterior uveitis in an otherwise immunocompetent, HIV-negative, 46-year-old female. Briefly, the patient initially presented with sudden-onset scalp hair loss that was initially diagnosed as atypical alopecia areata but failed to respond to typical alopecia areata-directed therapy. Concurrently, the patient developed ocular and neurologic symptoms, and the diagnosis of syphilis was rendered based on the constellation of clinical findings and cerebrospinal fluid/serologic testing. Syphilis-directed therapy resulted in the reversal of ocular and neurologic symptoms, as well as rapid scalp hair regrowth. This case highlights the importance of considering diagnosis of syphilis in the differential diagnosis for atypical alopecia. https://www.pagepress.org/journals/dr/article/view/10371Syphilitic alopeciaocular syphilistreponema pallidumneurosyphilissexually transmitted infection
spellingShingle Sumeetha Swaminathan
Irina Lerman
Kathleen Mannava
Luca Zatreanu
Anna De Benedetto
Mixed-pattern, essential syphilitic alopecia, uveitis, and papillitis in an immunocompetent patient with neurosyphilis
Dermatology Reports
Syphilitic alopecia
ocular syphilis
treponema pallidum
neurosyphilis
sexually transmitted infection
title Mixed-pattern, essential syphilitic alopecia, uveitis, and papillitis in an immunocompetent patient with neurosyphilis
title_full Mixed-pattern, essential syphilitic alopecia, uveitis, and papillitis in an immunocompetent patient with neurosyphilis
title_fullStr Mixed-pattern, essential syphilitic alopecia, uveitis, and papillitis in an immunocompetent patient with neurosyphilis
title_full_unstemmed Mixed-pattern, essential syphilitic alopecia, uveitis, and papillitis in an immunocompetent patient with neurosyphilis
title_short Mixed-pattern, essential syphilitic alopecia, uveitis, and papillitis in an immunocompetent patient with neurosyphilis
title_sort mixed pattern essential syphilitic alopecia uveitis and papillitis in an immunocompetent patient with neurosyphilis
topic Syphilitic alopecia
ocular syphilis
treponema pallidum
neurosyphilis
sexually transmitted infection
url https://www.pagepress.org/journals/dr/article/view/10371
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