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Behçet Disease — SCE Dermatology MCQ

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ModerateGenital DermatologyBehçet DiseaseSCE Dermatology

A 40-year-old woman with known Behçet disease develops painful genital ulcers. The ulcers are deep with a clean base and heal with scarring. What treatment is recommended for severe genital ulcers in Behçet disease?

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Correct answer: E — Topical potent corticosteroid and Colchicine; systemic immunosuppression (Azathioprine or anti-TNF) for refractory disease

Genital ulcers in Behçet disease can be severe, deep, and scarring. Management is stepwise: first-line includes potent topical corticosteroids and oral Colchicine for recurrence prevention. For refractory or severe genital ulcers, systemic immunosuppression with Azathioprine is recommended. Apremilast has evidence for oral aphthae in Behçet. For refractory mucocutaneous disease, anti-TNF therapy (particularly Infliximab or Adalimumab) is effective. Thalidomide is highly effective for mucosal ulcers but limited by teratogenicity and neuropathy. EULAR/BAD guidelines emphasise the importance of shared decision-making regarding treatment escalation.

Reference: BAD 2019 Behçet Guidelines; EULAR 2018