You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is triad of reiters disease are all except and explain in detail?
Reiters syndrome/ flies singer-Leroy disease: traid of urethritis , ahritis conjunctivitis Genetic predisposition: hla b 27 Causative organisms: Chlamydia trachomatis Salmonella Campylobacter Yersinia Shigella Clostridium diff iCal eah Clinical features: chronological appearance First manifestations: urethritis,conjunctivitis Ahritis Circulate Balan it is Ahritis: asymmetric , oligoaicular-predilection to lower extremity large joints, enthesitis( inflammation of tendons and ligaments at the sites of inseion into capsule or bone),sacroilitis. Rapid development of massive effusions. Sausage digitis-diffuse swelling of solitary finger or toe Joints: early morning stiffness and pain. Genitourinary: nonspecific urethritis, cervicitis, cystitis, hematuria, hydronephrosis,prostatitis, baholinitis,vaginitis, salpingitis Eye lesions: conjunctivitis,uveitis,iridocyclitis Cutaneous: keratoderma blemorrhagicum-hyper keratotic pustular lesions on erythematous base involving palms and soles.crusted thick horny lesions with thick scales circulate Balanitis-most common irregular moist superficial erosions or ulcers coalesce to form circinate lesions. ulceration over tongue-painless Cardiac: aoic is and hea block Renal- glomerulonephritis Investigations: Elevated acute phase reactants Elevated esr Jointfluid-pseudo sepsis- neutrophils>50000/ul, with reiters cells Radiology: enthesitis with periosteum reaction, asymmetric sacroilitis, spondylitis, non marginal syndesmophytes Conditions to be differentiated from reactive ahritis Treatment Ahritis: Physiotherapy, nsaids,indomethacin is the drug of choice. Dmards-sulfasalazine, methotrexate,hydroxychloroquine,prednisolone,acitretin in hiv patients Biological: infliximab,etanercept Cyclosporine, levamisole,gold,pencillamine. Skin and mucus membranes: topical keratolytis, topical coicosteroids,methotrexate,acetretin Iadvl textbook of dermatology