REITER'S SYNDROME

Reiter's syndrome broadly is the triad of nongonococcal urethritis, conjunctivitis, and arthritis associated with various skin changes. HLA-B27 incidence is very high and an increased percentage of HIV patients are affected. The disease often develops after dysenteric (e.g., Shigella, Salmonella, Yersinia) or urethritic (e.g., Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae) infections.

Clinical

Annular, serpiginous lesions with slightly raised borders on the glans penis of an uncircumcised man is called circinate balanitis. Circumcised men may exhibit papulosquamous lesions. Oral mucosal changes may occur including erosions, annular lesions, and geographic tongue. An analogous rash of the vulva has been reported. Psoriasiform lesions of the body may occur, and papulosquamous papules may occur on the soles (called keratoderma blennorrhagica).

Treatment

Topical steroids may be tried for the cutaneous changes. Acitretin may help the arthritis and cutaneous changes. For HIV-associated Reiter's disease, zidovudine or cimetidine therapy may be considered.

References

Dermatology Online Journal 14(12)

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