Alopecia Areata in a Patient Undergoing Treatment for Secondary Syphilis: A Diagnostic Challenge

A 17-year-old male treated for secondary syphilis developed patchy scalp alopecia, initially suspected to be syphilitic alopecia (SA). However, trichoscopy indicated alopecia areata (AA) due to findings like exclamation mark hairs and black dots, without signs of SA. After six weeks of topical clobetasol treatment, significant hair regrowth was observed. This case emphasizes the importance of trichoscopy in distinguishing AA from SA, preventing misdiagnosis, and avoiding anchoring bias, especially in patients with recent syphilis.