Behçet Disease Triad — ORE Part 1 MCQ

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HardOral MedicineBehçet Disease TriadORE Part 1

A 40-year-old woman presents with bilateral oral mucosal ulceration, genital ulceration, and anterior uveitis. She has experienced recurrent episodes over the past 2 years. What is the most likely diagnosis?

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Correct answer: E — Behçet disease

Behçet disease is correctly identified by the pathognomonic triad of recurrent oral ulcers, genital ulcers, and uveitis. ISG criteria require oral ulceration (present) plus any two of genital ulceration (present), eye lesions (anterior uveitis—present), skin lesions, or pathergy test. This patient meets criteria on three features. Recurrent aphthous stomatitis is limited to oral ulceration only. Crohn disease may cause oral ulcers and uveitis but genital ulceration is not typical. SLE can present with oral ulcers and uveitis but does not characteristically cause genital ulceration. Pemphigus vulgaris is an acantholytic blistering disease affecting oral mucosa but not genital sites or eyes. The recurrent, multisystem pattern over 2 years strongly supports systemic vasculitis (Behçet) over isolated or cutaneous conditions.

Reference: International Study Group criteria for Behçet's disease (1990). Lancet. 335(8697):1078–80; NHS Behçet's disease guidance; Birmingham Behçet's Centre (UK) application of ICBD 2014 criteria, Serology. 2017;1(1):47–54. https://www.nhs.uk/conditions/behcets-disease/