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Quiz of the Week: Painful urination, a swollen knee, and eye pain—what’s the cause?

Created January 12, 2018 by Figure 1
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A 31-year-old female presents to the emergency department with a two-day history of pain on urination and discomfort in her left knee and heel. She also complains of right eye pain, which is exacerbated by reading and bright lights. She recently recovered from a gastrointestinal illness two weeks earlier, but is otherwise healthy. Examination reveals a swollen left knee that is warm to the touch, and tenderness at the insertion point of the left Achilles tendon. Her right eye is red, and she has direct and consensual photophobia. Cells and flare are noted in the right anterior chamber on slit lamp examination. Based on this patient’s probable diagnosis, which of the following cutaneous manifestations is most likely?

A. Hyperkeratotic lesions
B. Evanescent erythemia
C. Bulls-eye rash
D. Purpuric papules

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