NEJM : 40 yoM 2 wk hx scaly foot rash, joint swelling & LBP. 1 wk ago had diarrhea & urethral discharge. Feet show keratoderma blenorrhagicum; PSO on scalp, trunk, hands, nail changes, +swollen joints, CRP 59/L, UA sterile pyuria, B27+ https://t.co/GgKWIbL9Br https://t.co/m0fbg8mJUc