Palmoplantar keratoderma in patient with Fiessinger-Leroy-Reiter syndrome

Reactive arthritis (synonym: Fiessinger-Leroy-Reiter syndrome, FLRS) is a multisystemic disease that includes the clinical triad of arthritis, urethritis, and conjunctivitis. Urogenital or intestinal infections are considered to be the etiological factors of FLRS development. Enterocolitic (epidemic) and urogenital (sporadic) forms of the disease are distinguished. The first one is associated with yersiniosis, salmonellosis, shigellosis and less commonly Campylobacter. The second one — with Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium. The mechanism of the FLRS occurence is not yet clear. The causative agents are thought to be triggers for the cytotoxic T-cell effect activa tion, which in turn leads to the formation of immune complexes and hyperproduction of proinflammatory cytokines (interleukin-1β, tumor necrosis factor α, etc.). The earliest manifestation of the syndrome is usually urethritis, a little later organ of vision is involved with the development of conjunctivitis, uveitis, keratitis. Then the large and small joints are affected. In addition, the pathological process can involve skin and mucous membranes with signs of balanitis circinata, palmoplantar keratoderma (keratoderma blennorrhagica), stomatitis. The sequence of symptoms occurence, infrequent disease incidence, especially in women, cause difficulties for practitioners in establishing the diagnosis. The presented clinical observation demonstrates the manifestation of palmoplantar keratoderma (keratoderma blennorrhagica) as a specific skin symptom in the syndrome’s composition. © 2024, Media Sphera Publishing Group. All rights reserved.