In this comprehensive and informative clinical review, (BMJ 2010;341:c3671), Box 1 Differential diagnoses should perhaps be expanded.
Patchy alopecia may be the late presenting symptom of tertiary syphilis, appearing many years after forgotten or undiagnosed past primary infection, where inadequate primary treatment, or, where antibiotic treatment for other infections, has suppressed usual secondary manifestations.
HIV infection and/or its treatments may cause hair loss problems and HIV treatment may interfere with syphilis diagnosis.
Rapid Response:
Great Deceivers
Dear Editor,
In this comprehensive and informative clinical review, (BMJ 2010;341:c3671), Box 1 Differential diagnoses should perhaps be expanded.
Patchy alopecia may be the late presenting symptom of tertiary syphilis, appearing many years after forgotten or undiagnosed past primary infection, where inadequate primary treatment, or, where antibiotic treatment for other infections, has suppressed usual secondary manifestations.
HIV infection and/or its treatments may cause hair loss problems and HIV treatment may interfere with syphilis diagnosis.
E-mail to forrie@brewsterweb.co.uk
1. Kennedy C., Syphilis presenting as hair loss. BMJ 1976;ii: 854.
2. Hunt N, McHale S., The psychological impact of alopecia. BMJ 2005;331: 951-3. (22 October.)
Brewster Martin F., BMJ 2005;331:1084 (5 November),
3. Program Abstr HIV Infect Women Conf HIV Infect Women Conf 1995 Wash DC. 1995 Feb 22-24; P88. See <http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102214998.html > (checked 3rd August 2010)
Geisler, William M., Southern Medical Journal. 97(4):327-328, April 2004.
Competing interests:
None declared
Competing interests: No competing interests