Seborrhoeic dermatitis is a chronic, recurring, benign skin inflammation that mainly affects the skin area with more oil glands.
Reactive arthritis, known as Reiter’s syndrome, is an inflammatory disease  of the joints following an infection. This is commonly triggered by a genito-urinary infection or gastroenteritis. The onset of joint swelling, aches and pains tend to occur 1 to 3 weeks following an infection that you may not be aware of.
The condition is slightly more common in men but can also affect women.
Although reactive arthritis is uncommon, we occasionally encounter the condition in primary care. This article serves to increase awareness of the medical condition and encourage patients to reach out early for appropriate medical treatment.
The classic triad symptoms of reactive arthritis include:
In addition to the typical triad symptoms, patients may also present with:
Reactive arthritis can be triggered following an infection of the genito-urinary system secondary to sexually transmitted  pathogens. STDs such as chlamydia trachomatis , Neisseria gonorrhoeae, mycoplasma genitalium, and ureaplasma urealyticum can cause infective urethritis and are associated with SARA.
SARA should be considered as one of the differentials when a young patient's profile is presented with unexplained acute joint inflammatory symptoms. Sexual history should be screened, and appropriate STD tests should be offered to avoid further delay in the treatment of the disease.
While abnormal joint symptoms are seen in SARA, patients may also present with abnormal urinary symptoms such as urethral discharge, pain during urination, increased urinary frequency, and testicular pain and swelling in men. In women, one may notice abnormal vaginal discharge, spotting in between periods, spotting after sex, or painful intercourse. Those that engage in anal intercourse may present with rectal discomfort, bleeding, discharge or tenesmus (feeling of incomplete defecation).
It is imperative to consider STD testing, as STD infections will require the correct dose and antibiotics to treat (depending on the type of STD), and STDs do not resolve on their own by the immune system.
An unexplained arthritis symptom can be an early manifestation of HIV. Also, reactive arthritis can occur in HIV patients. In these patients, the symptoms progression of reactive arthritis can be faster, and the condition can be more severe.
HIV infection should always be screened and considered as a differential in an unexplained inflammatory arthritis symptom.
Yes, it is possible. Non-STD infections involved in reactive arthritis include bacteria that cause gastroenteritis or dysentery (a severe form of diarrhoea). These pathogens include Salmonella spp, Shigella spp, Campylobacter jejuni, Clostridium difficile, and Yersinia enterocolitica.
Patients with non-STD-related reactive arthritis may present with a history of severe diarrhoea, abdominal discomfort, vomiting, nausea, etc.
Genetically, if a person is found to carry the gene  HLA-B27, they are 10 times more susceptible to developing reactive arthritis following an infection.
Human leukocyte antigens (HLAs) are proteins found on the surface of white cells. They are genetically programmed to aid the immune system to differentiate the body’s own cells and noxious external particles.
The presence of HLA-B27 can be detected through simple blood tests.
You should see a doctor if you have abnormal joint symptoms following recent diarrhoea or genital infection. If you have concerns about exposure to STDs, you should also see a doctor for further checkups and treatment.
Your doctor will obtain a medical history that includes your sexual history. A physical examination involving the genital region, skin surfaces, joints, eyes, and cardiac areas may be offered.
Depending on your individual presenting symptoms and risks of exposure, tests that your doctor can offer include:
In addition to the tests, your doctor may refer you to a rheumatologist, ophthalmologist, or even a cardiologist if there are concerns about the involvement of the disease in other organs of the body.
Treating the underlying infection with appropriate antibiotics is key in managing reactive arthritis. In the case of STDs, sexual partners should be screened and treated concurrently to reduce the risk of reinfections.
For the management of joint symptoms, non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed. In more severe conditions, steroids and immunosuppressive medications may be offered to manage the symptoms of reactive arthritis.
Arthritis symptoms in this condition tend to resolve over a few months, though some patients may have recurring arthritis or long-term chronic symptoms. Chronically inflamed joints are predisposed to joint damage, leading to loss of joint function.
Those with eye inflammations that are not treated adequately may run a risk of cataracts in the future or irreversible loss of vision.
Pre-Exposure Prophylaxis (PrEP) is offered when a person is at very high risk of acquiring HIV infection.
Post-Exposure Prophylaxis (PEP) is an antiretroviral medication (ART) option offer to people AFTER being possibly exposed to HIV to reduce the risk of becoming infected.
HIV infection will cause an infected person to produce antibodies as a response to fight the disease. HIV tests revolve mainly on detecting these antibodies to indicate whether HIV infection is present in the human body.
Sexually transmitted diseases (STD) or infections (STI) are serious conditions that can develop after having unprotected intercourse. At our clinic, we offer treatment for the following STDs:
Sexually Transmitted Diseases (STD), and alternatively known as sexually transmitted infections (STI) are spread via sexual contact, transmitted from a person to another through contact with body fluids such as blood, vaginal fluid or semen.