A case of Reiter's syndrome

Reiter's syndrome is a multisystemic disease characterized by a triad of urethritis, conjunctivitis and arthritis in association with skin lesions such as keratoderma blenorrhagica and balanitis circinata. Most cases of Reiter's syndrome are closely related to HLA-B27. We present a case of Reiter's syndrome that has typical clinicopathologic characteristics. A 37-year-old man had experienced weight loss and polyarthralgia for 7 months. He had painful swelling on the shoulders, elbows and knee joints, and hyperkeratotic plaques all over his body. He had no history of dysentry or sexual exposure, but was associated with the HLA-B27 antigen. Histopathology of the skin lesions on the back showed hyperkeratosis, rete ridge elongation and Munro microabscess. He was treated with corticosteroids, sulfasalazine, methotrexate, topical steroids and intra-articular corticosteroid injections. His skin lesions and urethritis were improved after 1 week, and his arthritis was improved after 6 months of therapy.