To the Editor.—
I was pleased to see one of the recent issues of The Journal containing 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
Murray KA. Syphilis and Leprosy. JAMA. 1982;247(15):2097. doi:10.1001/jama.1982.03320400017014
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