Balanitis circinata

Balanitis circinata (also known as circinate balanitis) is a dermatologic manifestation of reactive arthritis (sometimes also referred to as Reiter Syndrome although this eponym is falling out of use due to his association with the Nazi party^[1]) comprising a serpiginous annular dermatitis of the glans penis.^[2] Circinate balanitis is the most common cutaneous manifestation of reactive arthritis. However, circinate balanitis can also occur independently. Topical corticosteroid therapy is the most commonly used treatment, and topical calcineurin inhibitors have also been used successfully.^[3]

Reactive arthritis is characterized by nongonococcal urethritis, conjunctivitis, and arthritis. Reactive arthritis belongs to the group of arthritides known as the spondyloarthritides. There are two main types of reactive arthritis: post-venereal and post-enteric. Chlamydia trachomatis is felt to be the most common cause of reactive arthritis, in general. Until recently, even the terminology for the condition itself was unclear as multiple eponyms and names have been associated with reactive arthritis. In recent years, a great deal has been learnt about the epidemiology, pathophysiology and treatment of reactive arthritis and Chlamydia-induced reactive arthritis, specifically. Prospective epidemiologic data suggest that Chlamydia-induced reactive arthritis is underdiagnosed. Other truths being actively revealed include data suggesting that the pathogen itself (i.e., Chlamydia) might play an equally important role, or perhaps even more important, than the host with disease susceptibility; asymptomatic chlamydial infections might be a common cause of reactive arthritis and the two variants of reactive arthritis might respond differently to treatment in spite of the congruent clinical presentation. However, much about this syndrome remains shrouded in mystery. Recent data has been suggesting that Chlamydia-induced reactive arthritis might be a common condition that clinicians are simply failing to recognise. Therefore, an emphasis is placed on disease awareness since viable treatment options are emerging.^[4]

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