Behcet's Disease Flashcards
1
Q
Clinical features
A
classically: 1) oral ulcers 2) genital ulcers 3) anterior uveitis
thrombophlebitis and deep vein thrombosis (e.g. Budd Chiari: thrombosis in the hepatic vein)
arthritis
neurological involvement (e.g. aseptic meningitis)
GI: abdo pain, diarrhoea, colitis,
ERYTHEMA NODUSUM
2
Q
Mouth ulcer differentials
A
Simple aphthous ulcers are very common
Squamous cell carcinoma
Herpes simplex ulcers
Hand, foot and mouth disease (coxsackie A virus)
Inflammatory bowel disease (particularly Crohn’s disease)
Inflammatory conditions such as rheumatoid arthritis
Folate deficiency
3
Q
Genetics
A
HLA B51
4
Q
Diagnosis
A
Clinical diagnosis
Pathergy test involves:using a sterile needle to create a subcutaneous abrasion on the forearm
- This is then reviewed 24 – 48 hours later to look for a weal 5mm or more in size.
- It tests for non-specific hypersensitive in the skin.
- It is positive in Behçet’s disease, Sweet’s syndrome and pyoderma gangrenosum.
5
Q
Management
A
- Topical steroids to mouth ulcers (e.g. soluble betamethasone tablets)
- Systemic steroids (i.e. oral prednisolone)
- Colchicine is usually effective as an anti-inflammatory to treat symptoms
- Topical anaesthetics for genital ulcers (e.g. lidocaine ointment)
- Immunosuppressants such as azathioprine
- Biologic therapy such as infliximab
