Behçet Disease — RACP Adult Medicine MCQ

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ModerateRheumatologyBehçet DiseaseRACP Adult Medicine

A 28-year-old woman presents with recurrent oral and genital ulcers, erythema nodosum, and pathergy (papule >2 mm at 48 hours after needle prick). She is from Turkey. She develops posterior uveitis with retinal vasculitis. What is the most likely diagnosis?

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Correct answer: D — Behçet disease

Recurrent oral ulcers (≥3 per year), genital ulcers, skin lesions (erythema nodosum), positive pathergy test, and posterior uveitis/retinal vasculitis in a patient from along the Silk Road (Turkey, Middle East, East Asia) fulfils ISG criteria for Behçet disease. HLA-B51 is associated. Sight-threatening ocular disease requires systemic immunosuppression — azathioprine plus corticosteroids, with adalimumab for refractory cases.

Reference: ISG – 2014 – Behçet Criteria; EULAR 2024 Behçet Recommendations