Management of syphilitic hepatitis

Syphilis is a sexuality transmitted disease caused by Treponema pallidum. Liver involvement is very rarely seen and occurs in the second phase of the disease. Syphilitic hepatitis generally is mild clinical condition and is characterized by high serum alkaline phosphatase level, often with normal or only slightly abnormal transaminases. The skin eruptions are classically diffuse, symmetric maculopapular rashes involving trunk and extremities. Involvement of palms and soles is a strong clue to the diagnosis of secondary syphilis. Therefore, syphilitic hepatitis should be included in the early differential diagnosis in patient with abnormal liver enzyme, especially increased alkaline phosphatase, and rashes involving palms and soles.