|
|
| Line 1: |
Line 1: |
| ==Background==
| | #REDIRECT[[Behçet's disease]] |
| [[File:Behcet's.png|thumb|]] | |
| *Chronic small-vessel [[vasculitis]]
| |
| *Mucocutaneous, ocular, cardiovascular, renal, GI, pulmonary, urologic, musculoskeletal, CNS involvement
| |
| *Aphthous oral ulcers + ≥ 2 of following: Genital aphthae, cutaneous lesions, and neurological, oral or rheumatologic manifestations
| |
| | |
| ==Clinical Features==
| |
| *Age 20-30s most commonly
| |
| *More common in Turkey, Japan, Middle East
| |
| *Triad: Recurrent oral aphthous ulcers, genital ulcers, and [[uveitis]]
| |
| *Classically painful ulcer with necrotic center and red rim
| |
| *Skin: Subcutaneous nodules, pyoderma gangrenosum, cutaneous thrombophlebitis, pustular acne-like folliculitis
| |
| *Ocular: [[Uveitis]], iritis, [[optic neuritis]], [[vision loss]], hypopyon
| |
| *Neurologic: Brainstem and corticospinal tract syndromes, aseptic [[meningoencephalitis]], [[increased ICP]], [[cerebral sinus thrombosis]], optic nerve ischemia
| |
| *GI: Ulcers, obstruction, ileocecal perforation
| |
| *Inflammatory oligo[[arthritis]]
| |
| *Vasculopathy: Aneurysm, [[vasculitis]], superficial [[thrombophlebitis]], thrombosis
| |
| *Cardiac: [[Myocarditis]], [[endocarditis]], [[pericarditis]]
| |
| *Renal: [[Glomerulonephritis]], amyloidosis
| |
| *Pulmonary: [[Pleural effusions]], [[pulmonary hypertension]], pulmonary aneurysm
| |
| | |
| ==Differential Diagnosis==
| |
| *[[HSV]]
| |
| *[[lichen planus]]
| |
| *[[pemphigus vulgaris]]
| |
| *[[pemphigoid]]
| |
| *IVD
| |
| *[[SJS]]
| |
| *celiac disease
| |
| *[[SLE]]
| |
| *[[Sjogren's]]
| |
| *[[MS]]
| |
| *[[Sarcoidosis]]
| |
| *[[Syphilis]]
| |
| *[[TB]]
| |
| *malignancy
| |
| *[[Reactive arthritis]]
| |
| *[[HIV]]
| |
| *Other [[vasculitis syndromes]]
| |
| | |
| ==Evaluation==
| |
| *Clinical diagnosis
| |
| *ESR/CRP elevated
| |
| | |
| ===Classification===
| |
| *International Study Group Criteria
| |
| *Recurrent oral aphthae (at least 3 times in 1 year) + 2 of the following in absence of other systemic diseases:
| |
| **Recurrent genital aphthae
| |
| **Eye lesions
| |
| **Skin lesions
| |
| **A positive pathery test
| |
| | |
| ==Management==
| |
| *Rheumatology consult +/- multidisciplinary consults
| |
| *Oral and genital ulcers: [[Topical steroids]]
| |
| *Severe mucocutaneous disease: [[Prednisone]] 1mg/kg, low-dose thalidomide, or methotrexate
| |
| *Systemic disease: Steroid +/- [[cyclophosphamide]] or [[azathioprine]]
| |
| *Ocular: Prednisone + azathioprine and rapid ophthalmologist referral
| |
| *Cerebral [[venous sinus thrombosis]]- [[heparin]]
| |
| | |
| ==References==
| |
| <references/>
| |
| *Rosen's Emergency Medicine 8th edition. 2013. Chapter: Erythematosus and the Vasculitides. p1540.
| |
| *Smith EL, et al. Clinical manifestations and diagnosis of Behcet's disease. In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 22, 2014.
| |
| *Alnaimat FA, et al. (2014, Dec 16). Behcet Disease. eMedicine. Retrieved 12/22/2014 from http://emedicine.medscape.com/article/329099-overview
| |
| | |
| [[Category:Rheumatology]]
| |