musculoskeletal and connective tissue disorders
Behçet Disease
Diagnosis of Behçet Disease
Clinical criteria Behçet disease should be suspected in young adults with recurrent oral aphthous ulcers, unexplained ocular findings, or genital ulcers. Diagnosis of Behçet disease is clinical and often delayed because many of the manifestations are nonspecific and can be insidious. International criteriafor diagnosis include recurrent oral ulcers (3 times in 1 year) and 2 of the following: Recurrent genital ulcers Eye lesions Skin lesions Positive pathergy test with no other clinical explanation A positive pathergy test consists of the appearance of an erythematous induration with a sterile pustule in the skin 24 to 48 hours after the insertion of a sterile needle into the skin of the forearm. Laboratory tests (eg, complete blood count, erythrocyte sedimentation rate or C-reactive protein, serumalbuminand total protein levels) are done. Results are nonspecific but characteristic of inflammatory disease (elevated erythrocyte sedimentation rate, C-reactive protein, and alpha2-globulins and gamma-globulins; mild leukocytosis). Differential diagnosis includes Reactive Arthritis None Systemic Lupus Erythematosus (SLE) None Crohn Disease None Ulcerative Colitis None Overview of Hereditary Periodic Fever Syndromes None Herpes Simplex Virus (HSV) Infections None Behçet disease has no single pathognomonic finding but may be distinguished by its combinations of relapsing symptoms with spontaneous remissions and multiple organ involvement, particularly in patients with recurrent, deep mucosal ulcers. 