Departamento de Inmunología Unidad Académica de Biología Experimental, Universidad Autónoma de Zacatecas, Guadalupe, Zac, México.
J Clin Rheumatol. 2009 Dec;15(8):377-9. doi: 10.1097/RHU.0b013e3181c34260.
Reactive arthritis is the current name for the clinical triad characterized by arthritis, urethritis, and conjunctivitis, which develops over the course of a month or more. In some patients, this clinical triad is accompanied by circinate balanitis and keratoderma on the palms and soles. Balanitis, in some cases, is refractory to conventional therapy and can be recurrent, becoming a therapeutic challenge.
A total of 4 clinical cases of male patients, with ages ranging from 21 to 36 years old, presented with arthritis, conjunctivitis, urethritis, and recurrent circinate balanitis, which developed over a period of 1 to 6 months. All patients were treated with corticosteroids and sulfasalazine. In addition, one was treated with ciprofloxacin; however, balanitis was resistant to treatment in 3 patients.
As other treatments had failed, topical 0.1% tacrolimus was used, with excellent results, as the balanitis lesions were cleared during the first week of topical therapy.
We propose the complementary use of topical tacrolimus in cases of reactive arthritis associated with circinate balanitis.
反应性关节炎是当前的名称为临床三联征的特点是关节炎，尿道炎，和结膜炎，这是在一个月或更长时间的过程中发展。在一些患者中，这种临床三联征伴有环状阴茎头炎和掌跖角化病。在某些情况下，阴茎头炎对常规治疗有抗药性，且可能反复发作，成为治疗挑战。
共 4 例男性患者，年龄 21 至 36 岁，表现为关节炎、结膜炎、尿道炎和反复发作的环状阴茎头炎，病程 1 至 6 个月。所有患者均接受皮质类固醇和柳氮磺胺吡啶治疗。此外，1 例患者还接受了环丙沙星治疗，但 3 例患者的阴茎头炎对治疗有抗药性。
由于其他治疗方法均失败，我们使用了局部 0.1%他克莫司，结果非常好，在局部治疗的第一周内，阴茎头炎的病变就清除了。
我们建议在反应性关节炎合并环状阴茎头炎的情况下，补充使用局部他克莫司。
