Further information required includes the patient's full sexual and travel histories.
You also need to establish the presence or absence of urethral orgastrointestinal symptoms. The rashisapunctate, pustular, hyperkeratotic eruption on the soles of both of his feet. This is consistent with either pustular psoriasis or keratodermable norrhagica. Reiter's syndrome is an example of a reactive arthritis. Genitourinary pathogens such as Chlamydia trachomatis and Ureaplasma urealyticum and gut pathogens such as Shigella dysenteriae , Salmonella typhimurium , Yersinia enterocolica , and Campylobacter jejuni have been implicated.