Question

A 30-year-old patient presents with a history of flat lesions near the anal canal, rashes on the body, and hair loss that follows a particular pattern, as shown in the image. What is the diagnosis? 

• A. Trichotillomania
• B. Alopecia areata
• C. Secondary syphilis
• D. Malassezia

Hint:

In cases of secondary syphilis, remember the characteristic rash, mucosal lesions, and distinctive hair loss pattern. Confirm with serologic testing for syphilis.

Answer 1

The Correct Option is C

The presented case describes a 30-year-old patient with flat lesions near the anal canal, body rashes, and a specific pattern of hair loss. These symptoms align with secondary syphilis, an infectious disease caused by the bacterium Treponema pallidum. The condition is characterized by:

• Flat lesions (condylomata lata): These often appear in moist areas such as near the anal region.
• Body rashes: Typically affect the trunk and extremities and can be on the palms and soles, usually not itchy.
• Alopecia syphilitica: Moth-eaten pattern of hair loss which is patchy and non-cicatricial.

These clinical features support the diagnosis of secondary syphilis rather than the other options listed:

• Trichotillomania: Involves self-induced hair pulling, lacks associated skin rashes or lesions.
• Alopecia areata: Non-scarring hair loss with smooth bald patches, no skin lesions or rashes.
• Malassezia: Causes tinea versicolor; typically results in hypopigmented or hyperpigmented skin patches without hair loss.

Thus, given the symptoms presented, secondary syphilis is the most likely diagnosis.