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Alopecia areata

Causes well-demarcated, completely smooth, non-scarring patches of hair loss, unlike the diffuse, 'moth-eaten' pattern of syphilitic alopecia.

Apthous ulcer

Painful, recurrent ulcers in the mouth, unlike the typically painless chancre or mucous patches of syphilis.

Behcet's disease

A systemic vasculitis characterized by recurrent oral and genital ulcers, but also associated with uveitis and skin lesions like erythema nodosum.

Chancroid

Presents as multiple, painful, soft genital ulcers with ragged, undermined edges and is associated with painful inguinal lymphadenopathy (buboes).

Genital warts

Exophytic, cauliflower-like growths caused by HPV, distinct from the flat, broad condyloma lata or ulcerative chancre of syphilis.

Granuloma inguinale

Presents as a painless, progressive, beefy-red ulcerative lesion without regional lymphadenopathy; Donovan bodies are seen on tissue smear.

Pityriasis Rosea

Can mimic the rash of secondary syphilis, but typically starts with a 'herald patch' and has a 'Christmas tree' distribution on the back, and is not associated with positive syphilis serology.

Trichotillomania

Hair loss due to compulsive pulling, resulting in broken hairs of varying lengths and an irregular pattern, not the 'moth-eaten' pattern of syphilis.

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