Clinical and trichoscopic features of early congenital syphilis: a single-center cross-sectional study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction: Early congenital syphilis (ECS) remains an emerging public health problem in Latin America. Syphilitic alopecia (SA) is a rare and underreported manifestation in neonates, and its trichoscopic characteristics have not yet been systematically described. Methods: We have conducted a 1-year cross-sectional analytical study involving 30 neonates diagnosed with ECS, classified into clinical-serological scenarios 1 and 2 according to the Centers for Disease Control and Prevention (CDC) criteria, who were hospitalized at a tertiary care center in Guadalajara, Mexico. Sociodemographic, clinical, and serological data were collected. The presence of SA and associated trichoscopic findings was recorded. Neonates were stratified according to non-treponemal titers into two groups [<1:128 vs. ≥1:128 and/or the prozone phenomenon (PP)]. Associations were evaluated using the chi-squared test or Fisher's exact test, as appropriate. Logistic regression models were used to examine the association between trichoscopic characteristics and elevated neonatal Venereal Disease Research Laboratory (VDRL) titers. Results: = 0.006; odds ratio [OR]: 11.9; 95% confidence interval [CI]: 1.67-84.50). The most frequent trichoscopic abnormalities were exclamation mark hairs, coudability hairs, broken hairs, zig-zag/angulated hairs and Pohl-Pinkus constrictions. Among these abnormalities, exclamation mark and coudability hairs have shown the strongest associations with elevated neonatal VDRL titers. Conclusion: Trichoscopy enabled the identification of specific hair shaft abnormalities associated with increased serological activity, supporting its value as a complementary, non-invasive diagnostic tool in pediatric dermatology for evaluating neonates with ECS.
Source: Frontiers in Medicine
Institutions: Universidad de Guadalajara, Hospital Civil de Guadalajara
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7130459297