Abstract
Reiter’s disease observed in an HTLV-1 carrier is reported. A 62-year-old man presented urethritis, conjunctivitis, arthritis, and skin lesions. The skin lesions were similar to pustular psoriasis and disseminated over his entire body. Circinate balanitis with pustules was also observed. Laboratory investigations revealed leukacytosis (18,600/mm3), an elevated ESR (62mm/h) and an elevated CRP level (4.7mg/dl). HLA-B27 was absent. Spongiform pustules were observed in the skin lesions The general symptoms disappeared after the administration of minocycline (200mg/day) and methotrexate (10mg/week). Treatment with etretinate (40mg/day) and PUVA was also effective in treating the recurring psoriasiform lesions. Recurrence of the skin lesions and arthritis appeared after the administration of etretinate was halted because of its adverse reactions. His skin lesions and arthritis have since been well controlled by the administration of cyclosporin with an initial dose of 5mg/kg/day and a maintenance dose of 3mg/kg/day. The response to these treatment modalities indicates that the skin lesions of Reiter’s disease characteristically demonstrate psoriasis. The anti-chlamidia antibody was initially negative but became positive at the time of recurrence of the skin lesions. Therefore, the chlamidia infection may have been a causative factor in this patient. The role of HTLV-1 infection, however, remains obscure.
