Reiter's syndrome and keratosis blennorrhagica

Introduction The relationship of Reiter's syndrome and gonococcal keratosis blennorrhagica has intrigued us for a long time. Whenever a case of Reiter's syndrome with an associated keratoderma is presented at a dermatological meeting, an endless discussion arises as to the differential diagnosis. To add to the confusion, the diagnosis of arthropathic psoriasis is usually thrown into the discussion for good measure. Keratosis blennorrhagica, first described by Vidal19in 1893, is a syndrome of urethritis, arthritis, and often a conjunctivitis, associated with peculiar and characteristic skin lesions. Its gonorrheal origin was well established by Buschke2and others. As occasional cases appeared presenting the characteristic syndrome without gonorrheal infection, it became increasingly evident, even to Buschke,3that other agents might also be responsible for the development of this clinical picture. Case reports of "keratosis blennorrhagica without gonorrhea" began to appear, variously interpreted as a complication of nonspecific genitourinary infections