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Ulcerative vulvitis in Reiter's syndrome. A case report

S O Daunt, K E Kotowski, A P O'Reilly

    The British Journal of Venereal Diseases
    |December 1, 1982
    PubMed
    Summary

    Reiter's syndrome, a reactive arthritis, can present with severe vulvitis. This case highlights the diagnostic criteria and histological findings of this rare condition.

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    Area of Science:

    • Rheumatology
    • Dermatology
    • Gynecology

    Background:

    • Reiter's syndrome, now known as reactive arthritis, is a form of inflammatory arthritis.
    • It characteristically affects joints, eyes, and urethra, but can manifest with mucocutaneous lesions.

    Observation:

    • A case of acute Reiter's syndrome with severe vulvitis is presented.
    • Vulval lesions resembled circinate vulvitis, accompanied by vaginal discharge, dysuria, arthritis, conjunctivitis, and buccal ulceration.
    • Keratodermia blenorrhagica and the presence of HLA B27 antigen were noted.

    Findings:

    • Histological examination revealed shallow ulceration with dermal inflammatory infiltration.
    • Coincidental lichen sclerosus et atrophicus was identified, potentially masking the acute vulval lesions.

    Implications:

    • This case underscores the importance of considering reactive arthritis in the differential diagnosis of severe vulvitis.
    • Recognizing the diverse mucocutaneous manifestations is crucial for accurate diagnosis and management.
    • The interplay between acute inflammatory lesions and pre-existing conditions like lichen sclerosus et atrophicus requires careful evaluation.

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