A 23 year old male presented with psoriasiform dermatitis of one month duration in April 1999 and was found to be HIV seropositive. He was managed with PUVA therapy. His cutaneous lesions improved but no improvement in arthritis and in nail changes occurred. Patient discontinued the therapy and presented with relapse in July 1999 with a different clinical picture, now suggestive of Reitera€ s syndrome. He had keratoderma blenorrhagica and severe deforming arthritis. Such a case presents with difficulties in arriving at the diagnosis in the HIV era and allows limited therapeutic options for management.