{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T13:22:00Z","timestamp":1771420920742,"version":"3.50.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We have conducted a 1-year cross-sectional analytical study involving 30 neonates diagnosed with ECS, classified into clinical\u2013serological 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 [&amp;lt;1:128 vs. \u22651:128 and\/or the prozone phenomenon (PP)]. Associations were evaluated using the chi-squared test or Fisher\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty neonates were included, yielding an ECS prevalence of 3.05%. The vast majority of patients were male (76.7%) and were classified as CDC scenario 2 (70%). SA was identified in 23.3% of cases and was significantly associated with VDRL titers \u22651:128 or the presence of a prozone phenomenon (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.006; odds ratio [OR]: 11.9; 95% confidence interval [CI]: 1.67\u201384.50). The most frequent trichoscopic abnormalities were exclamation mark hairs, coudability hairs, broken hairs, zig-zag\/angulated hairs and Pohl\u2013Pinkus constrictions. Among these abnormalities, exclamation mark and coudability hairs have shown the strongest associations with elevated neonatal VDRL titers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1748553","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T12:50:51Z","timestamp":1771419051000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and trichoscopic features of early congenital syphilis: a single-center cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Cuauhtli Emmanuel","family":"Arambul-Carrillo","sequence":"first","affiliation":[{"name":"Antiguo Hospital Civil de Guadalajara-Fray Antonio Alcalde, Pediatric Dermatology Department, University of Guadalajara","place":["Guadalajara, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Enrique","family":"S\u00e1nchez-Due\u00f1as","sequence":"additional","affiliation":[{"name":"Dermatologic Institut of Jalisco \"Dr. Jos\u00e9 Barba Rubio\", Department of Dermatology, University of Guadalajara","place":["Guadalajara, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roc\u00edo Concepci\u00f3n","family":"Albores-Arguijo","sequence":"additional","affiliation":[{"name":"Antiguo Hospital Civil de Guadalajara-Fray Antonio Alcalde, Pediatric Dermatology Department, University of Guadalajara","place":["Guadalajara, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yocelin Nallely","family":"Lozano-Figueroa","sequence":"additional","affiliation":[{"name":"Antiguo Hospital Civil de Guadalajara-Fray Antonio Alcalde, Pediatric Dermatology Department, University of Guadalajara","place":["Guadalajara, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Guadalupe","family":"Castro-Mosqueda","sequence":"additional","affiliation":[{"name":"Adjunct Professor in the Specialty of Pediatric Dermatology, University of Guadalajara","place":["Guadalajara, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Aranda-Mendoza","sequence":"additional","affiliation":[{"name":"Adjunct Professor in the Specialty of Pediatric Dermatology, University of Guadalajara","place":["Guadalajara, Mexico"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e33009","DOI":"10.7759\/cureus.33009","article-title":"Congenital syphilis epidemiology, prevention, and management in the United States: a 2022 update","volume":"14","author":"Fang","year":"2022","journal-title":"Cureus"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/1761454","article-title":"A case of congenital syphilis presenting with unusual skin eruptions","volume":"2018","author":"Leung","year":"2018","journal-title":"Case Rep Pediatr"},{"key":"ref3","first-page":"12","article-title":"Pediatric syphilis: a five-year experience in a single Centre","volume":"2","author":"Rolotti","year":"2018","journal-title":"Dermatol Res Skin 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\u00dcnal","year":"2025","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"ref30","first-page":"66","article-title":"Syphilis in childhood: a retrospective study in a pediatric hospital","volume":"23","author":"Teller\u00eda","year":"2017","journal-title":"Dermatol Argent"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1111\/bjd.12459","article-title":"Hair in newborns and infants: clinical and dermoscopic evaluation of 45 cases","volume":"169","author":"Neri","year":"2013","journal-title":"Br J Dermatol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1007\/s11046-023-00709-1","article-title":"Trichoscopy for early diagnosis and follow-up of pet-related neonatal tinea capitis","volume":"188","author":"Zhi","year":"2023","journal-title":"Mycopathologia"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"112","DOI":"10.3389\/fmed.2017.00112","article-title":"A practical approach to the diagnosis and management of 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