Psychological impact of alopecia

Editor—I write with reference to the article by Hunt and McHale.¹ Late syphilis can be a cause of atypical alopecia. Some 30 years ago the BMJ ran an article about alopecia and syphilis.² Within a month, I saw a patient who had apparently been complaining of patchy “alopecia areata” for some time. The appearances and long history did not seem to fit any alopecia areata that I had seen. The “very long shot” serology result confirmed a specific causation, which turned out to be the unconfessed late result of an affair years previously. It was interesting that the specific treatment also cured another problem of “detergent hand dermatitis” as well as the alopecia.