ABSTRACT
Reactive arthritis is an inflammatory arthritis that arises following a gastrointestinal or urogenital infection, representing the classic interplay of host and environment and with the potential to involve multiple organ systems. The classic syndrome is a triad of symptoms, involving the urethra, conjunctiva, and synovium; however, the majority of patients do not present with this classic triad. It is considered as a form of spondyloarthritis, a group of diseases with inflammatory arthritis, negative rheumatoid factor, and genetic association with HLA-B27. The exact etiopathogenesis of reactive arthritis is not clear, but both genetic and environmental factors play a role. Urethritis and conjunctivitis are usually the first manifestations. Arthritis classically appears 10–14 days later, followed shortly by circinate balanitis. Keratoderma blennorrhagicum is a classic cutaneous finding found in 5%–30% of patients. Circinate balanitis is the most common mucocutaneous finding, observed in 20%–40% of patients and manifesting as painless serpiginous erosions. ReA has a variable course and may remit spontaneously or progress to chronic illness. Treatment involves a course of antibiotics like doxycycline and immunosuppressants like methotrexate. Biologics also have a role to play.
