Tacrolimus therapy for circinate balanitis associated with reactive arthritis

Area of Science:

• Dermatology
• Rheumatology
• Urology

Background:

• Reactive arthritis presents as a triad of arthritis, urethritis, and conjunctivitis.
• Associated symptoms can include circinate balanitis, which is often treatment-resistant.
• Recurrent balanitis poses a significant therapeutic challenge in reactive arthritis cases.

Observation:

• Four male patients (ages 21-36) presented with reactive arthritis, including conjunctivitis, urethritis, and recurrent circinate balanitis.
• Conventional treatments (corticosteroids, sulfasalazine, ciprofloxacin) were ineffective for balanitis in three patients.
• Balantitis lesions persisted despite standard therapeutic interventions.

Findings:

• Topical 0.1% tacrolimus was administered to patients with treatment-refractory balanitis.
• Excellent results were observed, with complete clearance of balanitis lesions within one week of therapy.
• Topical tacrolimus demonstrated high efficacy in resolving refractory circinate balanitis.

Implications:

• Topical tacrolimus is a promising complementary treatment for reactive arthritis-associated circinate balanitis.
• This approach may resolve therapeutic challenges posed by refractory balanitis.
• Further research into topical tacrolimus for reactive arthritis complications is warranted.