Moth-eaten Alopecia Research Articles

Malignant secondary syphilis presenting with rupioid lesions and moth-eaten alopecia.

Malignant secondary syphilis presenting with rupioid lesions and moth-eaten alopecia.

Moth-eaten alopecia: A clue to diagnosis of syphilis in a case of macular rash.

Moth-eaten alopecia: A clue to diagnosis of syphilis in a case of macular rash.

Epidemiological, Clinical, and Trichoscopic Features of Syphilitic Alopecia: A Retrospective Analysis and Systematic Review.

BackgroundSyphilitic alopecia (SA), which mimics other types of alopecia, is an uncommon manifestation of secondary syphilis. Trichoscopic features may facilitate its diagnosis. However, studies on SA and its trichoscopic characteristics remain limited.ObjectiveTo investigate the epidemiological, clinical, and trichoscopic findings and laboratory results, treatment, and outcomes of SA in Thai patients as well as to comprehensively summarize all trichoscopic features of SA through a systematic review.MethodsData on patients diagnosed with SA between December 2010 and December 2021 were obtained from their medical records and analyzed retrospectively. A systematic review of trichoscopic data, both from our institution and from studies registered in the PubMed, MEDLINE, and Embase databases, was conducted. A descriptive summarization was performed to comprehensively study the trichoscopic features of SA.ResultsOf the 205 patients with secondary syphilis, 23 patients with SA (symptomatic SA: 20, essential SA: 3) were included. The mean age was 27.6 ± 8.8 years, and male predominance was noted. The moth-eaten pattern was the most common SA presentation, and the parieto-occipital scalp was the most commonly affected area. All patients with SA achieved significant hair regrowth within 3 months of antibiotic therapy. Trichoscopic images were available for 20 patients with SA from our institute and were included in the systematic review. Fourteen articles provided information on 21 patients. Overall (N = 41), 26 (63.4%), 8 (19.5%), and 7 (17.1%) patients had moth-eaten alopecia, diffuse alopecia, and mixed alopecia, respectively. The most frequent trichoscopic finding was short regrowing hairs (78%), followed by decreased hair per follicular unit (75.6%), and empty follicles (51.2%). Unique features included flame hairs, bent tapering hairs, reddish-brown background, and brown rings around the perifollicular areas, each described in one case. However, the results were based only on case reports and small case series.ConclusionsGiven the progressively increasing frequency of SA, trichoscopic examination may be valuable when SA is suspected in patients with idiopathic alopecia; however, our findings are quite non-specific. The absence of exclamation mark hairs may help in the diagnosis of SA. Further comparative studies on other types of alopecia are required to determine the most useful diagnostic features.

Moth eaten alopecia as a manifestation of group of skin diseases: Reporting a series of 100 cases

Background: The moth-eaten alopecia is a characteristic clinical pattern usually of multiple small ill-defined patches of hair loss that was originally used to describe alopecia in syphilis but it is not well reported in other skin diseases. Objective: To record all patients that present with moth eaten alopecia and to do full clinical evaluation and classification aiming to find skin diseases that initially or during the course of the disease present with this pattern of hair loss. Patients and methods: This is a descriptive observational study of a series of 100 patients with moth-eaten alopecia. The data were collected in Baghdad city from 2014 to 2021 with an age range between 8-45 years involving 72 males and 28 females. Full laboratory evaluation including scraping for fungal infection and skin biopsy were performed when its indicated and justified. Results: The results of this study showed that lichen planopilaris, was recognized in 32(32%) patients, their ranged from 20-45 years with a mean of 25, while males consisted 31(96.8%) and females 1(3.2%). Discoid lupus erythematous was identified in 26(26%) patients, their ages ranged from 18-48 years with a mean 30 years including 7(26.9%) males and 19(73.1%). Females. Alopecia areata was recognized in 11(11%) patients, their ages ranged from 8-25 years with a mean 17 years, among them 6 males (54.5%) and 5 females (45.5%). Chronic folliculitis presented in 9(9%) male patients, their ages ranged from 20-30 years with a mean 25 years. Striae distensea was seen and identified in 9 patients their ages ranged from 3-10 years with a mean 7 years, among them males 8(89%) and females 1(11%). Scalp morphea was detected in 7(7%) patients, their ages ranged from 5-34 years with a mean of 29 years among them 5(71.5%) males and 2 (28.5%) females. Tinea capitis was seen in 4(4%) male patients, their age ranged from 3-5 years with a mean age of 4 years. While Juicy Psoriasis was encountered in two male patients (2%). Their ages ranged from 7 and 15 years with a mean 11 years. Conclusion: This is the first study describing and evaluating moth eaten alopecia as a characteristic and unique pattern of hair loss for many dermatosis. lichen planopilaris, discoid lupus erythematous, chronic folliculitis, striae distensae like were among the commonest diseases that cause this type of hair loss. This work will provide an important differential and diagnostic tool for clinician in order to establish early diagnosis and treatment, thus preventing the progress of the disease and scarring.

Sexual abuse leading to secondary syphilis in an intellectually disabled person: a case report

<p class="abstract">Syphilis is a sexual transmitted infection (STI) caused by a spirochete, <em>Treponema pallidum</em>. Condylomata lata is a characteristic lesion seen in secondary syphilis. Here we reported a case of 24 year old unmarried male with intellectual disability who presented with condyloma lata over the scrotum, prepuce and perianal region and with moth eaten alopecia over scalp since 1 month. Here the patients mother revealed he had promiscuous relationship with multiple friends, which is a sexual abuse since the patient is intellectually disabled. Clinically diagnosed as secondary syphilis. Venereal disease research laboratory (VDRL) test titre was reactive at 1:32 and <em>Treponema pallidum </em>hemagglutination test (TPHA) was positive. Biopsy was also done, which confirmed diagnosis. Single dose of injection benzathine penicillin G, 2.4 million units was administered intramuscularly. Patient did not develop a Jarisch-herxheimer reaction. On follow up his lesions healed and VDRL titres also came down and non-reactive at 3 months. Here in this case sexual abuse lead to secondary syphilis since patient was intellectually disabled so he couldn’t address his complaints clearly. Hence counselling was done to the patient and family members by dermatologist and psychiatrist.</p><p class="abstract"> </p>

Moth-Eaten Essential Syphilitic Alopecia in Human Immunodeficiency Virus-Positive Patient: A Case Report

Hair loss is rare to be reported as sole manifestation of secondary syphilis. Syphilitic alopecia consists of symptomatic syphilitic alopecia that presents with other secondary syphilis manifestation, and essential syphilitic alopecia which can be patchy ("moth-eaten" type), diffuse, or combination without other manifestations of secondary syphilis. Here we report a case of secondary syphilis in patient with Human Immunodeficiency Virus (HIV) that present with moth-eaten alopecia as a sole manifestation. A 35-year-old male with HIV complained hair loss on his scalp and eyebrows. Physical examination showed non scarring moth-eaten alopecia on his scalp and lossof lateral third of his eyebrows without other lesions. Serological test for syphilis was positive. He was treated with 2.4 millions unit of benzathine penicillin G (BPG), single dose intramuscular injection. Six months after injection, patient showed clinical and serological improvement. Syphilitic alopecia cannot be ruled out in patients with non scarring hair loss with unclear etiology. Serological tests are recommended especially for patients with history of high risk sexual behaviour.

Moth-eaten alopecia as a sole manifestation of secondary syphilis in an adolescent: Role of a dermatologist.

Moth-eaten alopecia as a sole manifestation of secondary syphilis in an adolescent: Role of a dermatologist.

Moth-eaten alopecia in secondary syphilis

Moth-eaten alopecia in secondary syphilis

Moth-Eaten Symptomatic Syphilitic Alopecia Associated with Human Immunodeficiency Virus—A Case Report

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.

Lichen Planopilaris is a Common Scarring Alopecia among Iraqi Population

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.

Moth-eaten alopecia: a sign of secondary syphilis

A 39-year-old man presented with a three-month history of progressive hair loss on his scalp. Five months earlier, he had a generalized rash that lasted for three weeks. He reported having sexual intercourse without condoms with multiple female partners, but he had no history of genital ulceration.

Palmar and plantar keratoderma, visual loss, and alopecia

A 33-year-old healthy man presents with a 2-month history of progressive visual loss, itching lesions on the palms and soles, and hair loss. The physical examination reveals hyperkeratotic plaques on the palms and soles (Fig 1), moth-eaten alopecia (Fig 2), and oropharyngeal candidiasis. An ophthalmic examination reveals panuveitis with nonreactive pupils and irregular border. The rest of his cutaneous and neurologic examination is normal.

Alopecia syphilitica-report of a patient with secondary syphilis presenting as moth-eaten alopecia and a review of its common mimickers

Alopecia syphilitica is an uncommon manifestation of secondary syphilis, occurring in only 4 percent of these individuals. 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. A 38-year-old, otherwise asymptomatic, homosexual man is described whose initial presentation of syphilis was patchy, moth-eaten, alopecia. In addition, differentiating features of alopecia syphilitica and other similar appearing non-cicatricial alopecias are reviewed. Conditions that mimic moth-eaten alopecia include other localized and non-cicatricial alopecias, such as alopecia areata, alopecia neoplastica, tinea capitis, and trichotillomania. The distinguishing clinical and laboratory features of alopecia syphilitica include other mucocutaneous changes associated with secondary syphilis, when present, and a positive serology for syphilis. The treatment of choice is a single intramuscular injection 2.4 million units of benzathine penicillin G for patients without immunocompromise; however, our patient was treated with three weekly doses because of concern about possible HIV positivity. The hair loss usually resolves within 3 months of treatment.

The moth-eaten alopecia of secondary syphilis. A histopathological study of 12 patients.

Moth-eaten alopecia (MEA) is a characteristic manifestation of secondary syphilis. Clinically, this form of alopecia may be confused with trichotillomania, traction alopecia, and alopecia areata. The histopathological features of the latter conditions are well described, but information regarding the histology of syphilitic MEA is sparse. We systematically documented the histopathological features of 12 patients with MEA. Characteristic features included follicular plugging; a sparse, perivascular and perifollicular lymphocytic infiltrate; telogenization and follicle-oriented melanin clumping.

Syphilis and Leprosy

To the Editor.— I was pleased to see one of the recent issues ofThe Journalcontaining a good amount of material on sexually transmitted disease (STDs). Within one issue, there were two articles on atypical manifestations of gonococcal infections (1981; 246:242, 246), an article on secondary syphilis (1981;246:250), and an announcement on the First STD World Congress for November 1981 (1981; 246:217). One dermatology question in the same issue concerned a case of presumed alopecia areata in a 26-year-old man with oral ulcers, cervical lymphadenopathy, arthralgias, anemia, and, possibly, hepatitis (1981; 246:284). All of these signs and symptoms may occur with secondary syphilis, although the moth-eaten alopecia of syphilis may involve more diffuse thinning of the hair rather than the "exclamation point" hairs seen in bald spots in alopecia areata. 1 Syphilitic alopecia, of course, is accompanied by positive serological test results. Since syphilis is so easily treated in

ALOPECIA AREATA ASSOCIATED WITH REFRACTIVE ERRORS

Although alopecia areata has been known for many years as a distinct clinical entity offering little difficulty in differential diagnosis, the cause remains unknown, as evidenced by the many case reports suggesting different theories of causation. Typical alopecia areata may appear at any age, in either sex, and may involve the scalp, eyebrows or bearded region. It usually occurs with a sudden asymptomatic loss of hair, leaving a sharply circumscribed oval or irregular smooth noninflammatory area of almost complete alopecia, containing only a few so-called exclamation point hairs. In rare instances the alopecia may become total. In differential diagnosis, syphilitic moth-eaten alopecia, ringworm of the scalp, trichotillomania, folliculitis decalvans, lupus erythematosus, scars and radiation alopecia must be considered, as well as acute local infectious processes. A patient with the usual case of alopecia areata, with or without treatment, ordinarily shows regrowth of hair in a period of three to six