A 46-year-old Japanese male was referred to us with a 2-month history of cranial hair loss. Physical examination revealed diffuse hair loss in the frontal, parietal, and temporal regions without other obvious skin symptoms. He had had a sexual contact 5 months before the first visit. Laboratory tests revealed RPR of 6,120 R.U. and TP of 7,140 T.U. We therefore made a diagnosis of syphilitic alopecia. Oral amoxicillin was administered with prompt improvement of his hair loss. After 24 weeks, his hair growth returned to normal, and his RPR had decreased to 5.1 R.U. The likelihood of syphilitic alopecia should be considered in patients with head hair loss.
Curvularia lunata is a ubiquitous saprophytic fungus found in soil and decaying plants. This fungus is well known as a causative agent of keratitis and sinusitis cases, but cutaneous infections are rare. Here we present the first report of a cutaneous C. lunata infection in Japan and review previous cases published in the English literature. The patient was an 81-year-old healthy Japanese male with an asymptomatic maceration, scaling lesion, rhagades and pigmentation in the webspace between the fourth and fifth toes of the left foot. Direct examination of a skin scraping in 10% potassium hydroxide solution revealed dark brown septate hyphae. C. lunata was isolated and identified using both morphological and molecular methods. The lesion disappeared after two months of topical treatment with luliconazole ointment.