Arthritis Q&A by Dr. Shiel

Answer:

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Reiter syndrome is considered a systemic rheumatic disease. This means it can affect other organs than the joints, to cause inflammation in areas such as the eyes, mouth, lungs, kidneys, heart, and skin.

The classic areas of the skin that can become involved with Reiter syndrome are the palms of the hands and soles of the feet (although other body surface areas can less commonly be affected). Inflammation in these areas can come and go. When present, it causes reddish, raised pustules that can be painful and tender. These patchy areas can group together and peel periodically. This skin inflammation is also referred to as keratodermia blennorrhagicum (KB). It is microscopically similar to another skin disease called pustular psoriasis.

KB can be treated with topical medications. These include skin softeners (emollients) and medications that clear off the peeling dry skin (keratolytic medications). Sometimes these treatments are used along with vitamin D creams, such as calcipotriene.

It is important to note that sometimes emotional stresses and medications (such as propanolol, Vasotec, and hydroxychloroquine/Plaquenil) have been reported to aggravate the skin inflammation.

Another classic area of skin inflammation in males with Reiter syndrome is around the penis. The skin around the shaft and tip (glans) penis can become inflamed and scale. The inflammation around the penis can be helped by cortisone creams (such as Topicort). The skin inflammation of the penis of males with Reiter syndrome is referred to as circinate balanitis.

Thank you for your question.