A 28-year-old previously healthy man presents with thick crusting and hyperkeratosis of the palms and soles, urethritis, and one month of peripheral arthritis. Which of the following is true regarding his condition?

A. Females and males are equally affected

B. About 20% of patients will have a long-term disease that results in enthesitis and destructive arthritis.

C. TNF-alpha inhibiting agents have no role in the treatment of this condition

D. Patients must have urethritis, conjunctivitis, and arthritis for diagnosis

E. Chlamydia cervicitis is not associated with this condition

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