REITERS SYNDROME - A CASE REPORT
Abstract
Abstract : Reiters syndrome , a form of reactive arthritis is
characterized by a triad of arthritis, non-gonococcal urethritis,
conjunctivitis and psoriasiform cutaneous and mucosal
lesions.It usually occurs following an an intestinal or genito
urinary tract infection. A 35 yr old male presented with
widespread raised lesions of six months duration and joint
pain of 2 months duration. The patient gave a history of
unprotected sexual contact with an unknown female 7 months
back. He also had a history of recurrent dysuria suggestive of
urethral inflammation, which subsided spontaneously. The
patient also gave a history of redness of both the eyes and
discharge from both the eyes 3 months back. Dermatological
examination revealed multiple well circumscribed
erythematous scaly plaques of varying sizes present all over
the body and palmo plantar keratoderma (keratoderma
blennorrhagicum) . Finger and toe nails showed
onyhodystrophy and subungual hyperkeratosis. Skin biopsy
revealed hyperkeratosis, parakeratosis, neutrophilic
microabscesses, regular acanthosis, and dermal inflammatory
infiltrate. Urine culture showed growth for Proteus vulgaris.
HLA B27 was positive in the patient. The patient was treated
with Methotrexate and the cutaneous lesions resolved in 7
weeks. This case is presented for the classical cutaneous
manifestations and the rapid response to systemic
Methotrexate.
Keyword :Reiters syndrome, HLA B 27, Keratoderma
blennorrhagicum
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