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Behcet Disease Treatment — MFDS Part 1 MCQ

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ModerateHuman DiseaseBehcet Disease TreatmentMFDS Part 1

A 29-year-old patient with established Behçet disease has recurrent, painful aphthous oral ulcers without major-organ involvement. Which option best describes the stepwise pharmacological management of the oral ulceration in UK practice?

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Reveal the answer and explanation

Correct answer: E — Topical corticosteroid initially; colchicine for recurrent disease; specialist systemic therapy if refractory

Explanation lettering: E = shown as A · C = shown as B · D = shown as C · B = shown as D · A = shown as E

A is correct. Behçet oral ulcers are inflammatory mucocutaneous lesions. A topical corticosteroid, delivered as a mouthwash, gel, lozenge or spray, is generally used for active oral ulceration. Colchicine may be prescribed by the specialist team to prevent or control recurrent ulcers. Severe or refractory disease may require systemic immunosuppressant or biological therapy. Systemic prednisolone or ciclosporin is not routine first-line treatment for uncomplicated oral ulcers, making C incorrect. Antibiotics and chlorhexidine do not treat the underlying inflammatory disease, although antimicrobials may occasionally have an adjunctive role; therefore B and D are incorrect. Aciclovir and valaciclovir treat herpesvirus infection and have no established role in typical Behçet aphthous ulceration, excluding E.

Reference: NHS, Behçet's disease – Treatment, section 'Ulcers and skin lesions', last reviewed 6 April 2023. https://www.nhs.uk/conditions/behcets-disease/treatment/