Mixed-Pattern, Essential Syphilitic Alopecia, Uveitis, and Papillitis in an Immunocompetent Patient with Neurosyphilis

This case study describes a 46-year-old immunocompetent, HIV-negative female who presented with mixed-pattern syphilitic alopecia (SA) and ocular syphilis (OS) in the form of anterior uveitis, alongside neurologic symptoms. Initially misdiagnosed as atypical alopecia areata, the correct diagnosis of syphilis was made through clinical findings and cerebrospinal fluid/serologic testing. Syphilis-directed therapy led to the resolution of ocular and neurologic symptoms and rapid hair regrowth, emphasizing the need to consider syphilis in differential diagnoses for atypical alopecia.