Alopecia specifica diffusa

Last Updated: 2022-04-01

Author(s): Anzengruber F., Navarini A.

ICD11: ED70.Z

Non-scarring hair loss occurring in patients suffering from syphilis.

Syphilis infection

Non-scarring, diffuse, partly moth-eaten alopecia.

  • Anamnesis
  • Clinical picture
  • Laboratory
    • Addiction tests: TPHA serology, VDRL test
  • If negative and clinical suspicion continues, repeat serology after 3- 6 months
  • Confirmatory reaction: FTA test, FTA Abs test

Good prognosis with adequate treatment.

  • Benzathine penicillin as a depot injection i.m. 1.2 million IU in weeks 0, 1 and 2

In case of penicillin allergy:

  • Erythromycin p.o 500 mg 4x tgl.
  • Azithromycin p.o. 500 mg 1x tgl.
  • Ceftriaxone i.v./i.m. 250-1000 mg

  1. Jordaan HF, Louw M. The moth-eaten alopecia of secondary syphilis. A histopathological study of 12 patients. Am J Dermatopathol. 1995 Apr;17(2):158-62. 
  2. Glover RA, Piaquadio DJ, Kern S, Cockerell CJ. An unusual presentation of secondary syphilis in a patient with human immunodeficiency virus infection. A case report and review of the literature. Arch Dermatol. 1992 Apr;128(4):530-4.