A 27-year-old man with secondary syphilis shows patchy loss of scalp hair leaving a moth-eaten appearance, along with his maculopapular rash. The hair loss in this setting is best described as:
- A Scarring alopecia due to follicular destruction by gummas
- B Non-scarring 'moth-eaten' alopecia, a classic feature of secondary syphilis ✓
- C Telogen effluvium triggered by Jarisch-Herxheimer reaction
- D Tinea capitis with black dot sign
Correct answer: B. Non-scarring 'moth-eaten' alopecia, a classic feature of secondary syphilis
Explanation
Secondary syphilis produces a characteristic patchy, non-scarring 'moth-eaten' alopecia affecting the scalp, eyebrows, and beard, caused by perifollicular treponemal inflammation. It resolves after penicillin therapy. Gummatous scarring belongs to tertiary syphilis, and telogen effluvium is diffuse rather than patchy.
Reference: Rook's Textbook of Dermatology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.