Behçet's Disease — RACP Adult Medicine MCQ

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ModerateGeneral Internal MedicineBehçet's DiseaseRACP Adult Medicine

A 28-year-old man presents with recurrent oral ulcers, genital ulcers, and a pustular rash at the site of a recent blood draw (positive pathergy test). He has bilateral anterior uveitis. What is the most likely diagnosis?

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Correct answer: D — Behçet's disease

The combination of recurrent oral ulcers, genital ulcers, uveitis, and positive pathergy test fulfils the International Study Group criteria for Behçet's disease. Pathergy (pustular reaction at sites of minor skin trauma) is highly specific. Posterior uveitis and retinal vasculitis are sight-threatening complications requiring aggressive immunosuppression. First-line treatment for mucocutaneous disease is colchicine; for sight-threatening ocular disease, infliximab or adalimumab plus azathioprine.

Reference: eTG – 2025 – Rheumatology; EULAR – 2018 – Behçet's Disease Recommendations