DOI: 10.36347/sjmcr.2015.v03i11.024

Pages: 1088-1091

Reiter’s disease is a genetically orchestrated immune response focussed on skin and joints, commonly presenting with a triad of conjuctivitis, acute non supurative seronegative arthritis and urethritis. A 24 year old female presented with dark colored raised oozy lesions around face, umbilicus, and thighs, upper and lower extremities since 1 month not responding to antibiotics. She had itching all over body, foul smelling vaginal discharge, knee joint pain, pedal edema with history of diarrhea 1 month back. Skin examination showed multiple well defined scaly plaques with few horny nodules over trunk, upper and lower extremities, face and back and keratoderma blenorrhagica like lesions on palms and soles. Genital examination showed curdy white foul smelling discharge. Investigations revealed high ESR (60mm/hr), microcytic hypochromic anaemia, Rheumatoid factor-negative, Joint fluid showed 40% of polymorphs with 2500/cmm, elevated CRP. Cervical vaginal swab shows klebsiella. Skin biopsy shows epidermal hyperplasia with acanthosis and parakeratosis with suprapapillary thinning and infiltration of neutrophils. On the basis of clinical findings and investigations, diagnosis of Reiter’s disease was made and Tab Doxycycline 100mg twice daily, Tab. Prednisolone 40 mg once daily and Tab methotrexate 7.5 mg to 10 mg in varying doses were started with considerable improvement .This case is presented due to rarity of the disease.