Bakkour W, Chularojanamontri L, Motta L, Chalmers R J G
Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
Clin Exp Dermatol. 2014 Apr;39(3):333-5. doi: 10.1111/ced.12299.
Circinate balanitis is the commonest cutaneous manifestation of reactive arthritis (Reiter syndrome), but can also occur independently. Topical corticosteroid therapy is the most commonly used treatment, and topical calcineurin inhibitors have also been used successfully. We report a case of a 20-year-old man who presented with discrete erythematous patches with slightly raised keratotic annular borders on his glans penis. He also developed geographic tongue and severe arthritis. A clinical diagnosis of circinate balanitis was made, which was supported by the psoriasiform features on skin biopsy. The patient failed to respond to topical 0.05% clobetasol propionate cream, but a novel approach using a combination of dapsone and topical 0.1% tacrolimus ointment successfully cleared his rash.
环状龟头炎是反应性关节炎（赖特综合征）最常见的皮肤表现，但也可单独出现。局部用皮质类固醇疗法是最常用的治疗方法，局部用钙调神经磷酸酶抑制剂也已成功应用。我们报告一例20岁男性患者，其龟头出现边界有轻微隆起角化的环形红斑。他还出现了地图舌和严重关节炎。临床诊断为环状龟头炎，皮肤活检的银屑病样特征支持这一诊断。患者对局部用0.05%丙酸氯倍他索乳膏治疗无效，但采用氨苯砜和局部用0.1%他克莫司软膏联合使用的新方法成功清除了他的皮疹。
