iatroX Rounds #52
The clues
- 1
A 30-year-old man of Turkish descent presents with a one-year history of painful, recurrent ulcers in his mouth that take two weeks to heal.
- 2
He reports that similar painful sores occur on his scrotum and he has recently experienced episodes of blurry vision and red eyes.
- 3
His history is notable for migrating joint pains in his knees and wrists, along with intermittent colicky abdominal pain.
- 4
On examination, he has multiple shallow oral aphthous ulcers and tender, red nodules on his shins.
- 5
Slit-lamp examination by an ophthalmologist identifies anterior uveitis with a hypopyon in the right eye.
- 6
Pricking the skin with a sterile needle results in the development of a small, sterile pustule at the site 48 hours later.
Behçet's disease is a chronic, relapsing multi-system vasculitis characterised by recurrent oral and genital ulceration, ocular inflammation, and skin lesions. It is most common in individuals from the Mediterranean and Middle East, following the historic Silk Road distribution.
- Recurrent, painful oral and genital ulcers
- Anterior or posterior uveitis which can lead to vision loss
- Skin lesions such as erythema nodosum and acneiform eruptions
- Systemic involvement including the joints, gastrointestinal tract, and central nervous system
for education and entertainment. not medical advice.