Reiter's Syndrome

Reiter's syndrome is one of the reactive arthritis , characterized by a triad of arthritis, urethritis, conjunctivitis, and skin or mucosal lesion for more than 4-6 weeks.

It involves the large joints, ligaments and tendons attachment site. Reiter's syndrome usually develops following an intestinal or a genital/urinary tract infection (urethritis, prostatitis, cervicitis, & cystitis), conjectivitis, and skin lesions (keratoderma blenorrheigica). These symptoms may occurs once or recur throughout life. Reiter’s syndrome is more likely to occur in individuals who are genetically predisposed. It usually occurs 1 to 3 weeks following a mild or severe diarrhea or urinary tract infection.

Symptoms

Arthritis :

People with Reiter's syndrome experience swelling and tenderness of the ankle or knee, lower back, heels of the foot, toes and fingers, often called "sausage digits" because of their shape, tenderness at the site of attachment of tendon (enthesiopathy).

Urethritis is commonly described in Reiter's. But in reality eliciting history or demonstrating signs of urethritis have always been difficult.

Conjunctivitis is described with the Reiters syndrome and often found in patients with the Reiter’s syndrome during examination.

Skin lesion of Reiters syndrome are characteristics and they start as erythematous macule to skin colored papule. In the process of evolution it turns pseudo vesiculopustular to erythematous plaque covered with heaped up crust. On the palm and sole often the thick crust falls off leaving a collaret of scaling in the lesion called keratoderma blenorrheagica.In mucosa it present as cercinate lesion on the glans and oral mucosa

Diagnosis

Diagnosis is based upon the findings of the classic triad, evolution of the skin lesion and heaped up crust.

Treatment of Reiter's Syndrome

The objective of treatment is to reduce joint pain and inflammation; prevent or decrease the amount of joint damage; and restore the function of damaged joints. Treatment urethritis, conjunctivitis, and skin lesions. The most common drugs used are non-steroidal anti-inflammatory drugs (NSAIDS) such as indomethacin, diclofenac, or phenylbutazone. In severe cases, folic acid antagonists such as methotrexate is used which relieve joint inflammation and improves skin lesion .

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