Lone circinate balanitis and genital keratoderma: underdiagnosed presentations of chlamydia infection in men?

Objectives To describe the experience in a genito-urinary clinic of lone circinate balanitis and genital keratoderma Design Retrospective analysis of all male GU clinic attenders diagnosed as circinate balanitis and genital keratoderma, chlamydia infection or balanitis in a 12 month period. Subjects Attenders at a North London genito-urinary clinic. Main outcome measures Proportion of male patients with chlamydia or balanitis who had circinate balanitis and/or genital keratoderma, Results Six men had circinate balanitis and/or keratoderma of the glans.;SU six were chlamydia positive whereas of 179 men with balanitis of other causes, only two had chlamydia(P < 0.001). Only one of the men with circinate balanitis had symptoms of urethritis although. all had microscopic urethritis. Five of the 6 men (83%) were from ethnic minorities who constitute only 35% of our total male clinic attenders. Only one patient had any other manifestation of Reiter's syndrome (oral ulceration) and none had arthritis or conjunctivitis. Conclusions Circinate balanitis or genital keratoderma occurring as single entities amongst our clinic population seems to be more common and more strongly associated with chlamydia infection than previously published Literature would suggest.