Medical MemorandaMIDALeJOUWNL keratodermia spread to involve all four limbs, the back, the face, and the scalp. The lesions progressed from a macular eruption to vesicular and pustular stages, finally becoming hard scaling keratotic plaques, which on the feet were painful and irritating. Fresh lesions appeared adjacent to areas of healing ( Fig. 1), and in view of their severity oral prednisone 40 mg. daily and topical hydrocortisone were prescribed. The arthritis was also treated with indomethacin with partial relief, but after a few days of steroid therapy her pyrexia subsided, joint pains were further relieved, and there was a noticeable improvement in the skin lesions. After 11 weeks in hospital she was discharged, the prednisone being gradually reduced. At the time of this report no fresh skin or mucosal lesions had appeared, and repeat radiographs of the hands, the feet, and sacroiliac joints were normal. Histological examination of involved skin ( Fig. 2) showed spongiform pustules in the upper epidermis, acanthosis, infiltration with polymorphs, and hyperkeratosis. The underlying dermis showed mild perivascular chronic inflammatory cell infiltration. (Hancock, 1960) and are painless and superficial. The mucous membrane lesions usually precede the skin lesions and may also occur before the onset of arthritis (Nicol, 1966). It is likely that the oral lesions in this patient were present on admission but were overlooked, for when the diagnosis of Reiter's disease became obvious with the eruption of keratodernia blennorrhagica, closer inspection of the tongue showed lesions practically healed. An extremely rare feature in this case was that the keratodermia involved the face. Though lesions of the scalp may extend a little on to the forehead (King, 1964), facial involvement in Reiteres disease is practically never seen (Oates, 1970).Treatment of Reiter's disease with steroids is not indicated unless the illness is severe. In the present case the administration of prednisone resulted in cessation of pyrexia for the first time since admission, healing of skin lesions, and a shortened stay in hospital.I should like to thank Professor M. D. Milne, Westminster