Which diagnosis is associated with keratoderma blenorrhagicum and balanitis?

• A. Reactive Arthritis (Reiter's)
• B. Gout
• C. SLE
• D. Psoriatic arthritis

Answer: (A)

Keratoderma blenorrhagicum and balanitis are mucocutaneous features that strongly point to reactive arthritis, an inflammatory arthritis usually triggered by an infection in the gut or urinary tract. Reactive arthritis often presents with arthritis plus urethritis and conjunctivitis, and it commonly includes skin and mucous membrane lesions such as keratoderma blenorrhagicum on the palms or soles and inflammation of the glans (balanitis). This association with these specific skin and genital lesions makes reactive arthritis the best fit when you see them together.

Gout is driven by urate crystal deposition and typically presents as acute joint pain without these mucocutaneous findings. SLE involves different skin and systemic manifestations rather than this particular set of lesions. Psoriatic arthritis can involve skin and joints, but keratoderma blenorrhagicum and balanitis are not characteristic features of psoriatic arthritis.