Unusual Cause for Baldness Inspires the Muse

To the Editor  —It appears that one of the effects of direct consumer advertising of prescription drugs is the intemperate demand for therapy by a presold and pressing patient.A 29-year-old man was annoyed that I actually wished to examine him and order laboratory tests. Responding to the Rogaine (minoxidil) television advertisements, he simply wanted a prescription so he could get along with growing hair. Clinically, there was diffuse thinning, with many long hairs with depigmented bulbs (telogen hairs) easily dislodged with gentle traction. The remainder of the physical examination was unremarkable. He denied recent illness, sores, or rashes. His serological test for syphilis was reactive at a 1:320 dilution. The hair loss was his only clinical manifestation of secondary syphilis.The limerick muse inspires the following cautionary rhyme:A young man on Rogaine rub bent, Desired to Docs circumvent, His hairs, tho' they're willin', Really need penicillin, So instead