PIP: A case of alopecia as the only symptom of secondary syphilis in a 32-year old Indian man is described. The man presented with patchy hair loss on the scalp, eyebrows, chest and legs, and generalized nontender lymphadenopathy. Laboratory tests were positive for RPR (rapid plasma reagin test) at 1:64, FTA Ab (fluorescent treponema antibody absorption test). He had a history of heterosexual contact 9 months previously. He was treated with procaine penicillin 600,000 units im daily for 10 days, and hair growth resumed within 6 weeks. Hair loss described as "moth eaten alopecia" is common in secondary syphilis. Other patterns of hair loss related to treponema infection include diffuse, extensive alopecia as a penicillin reaction, and peripheral scalp[ alopecia in infants with congenital syphilis.