Behcet's Flashcards
what is behcet’s
systemic inflammatory disease involving autoimmune-mediated inflammation of arteries and veins
a/w HLA-B51, MICA6
what is HLA-B51?
split antigen of HLA-B5
where is behcet’s common
old silk road from Mediterranean to China (e.g. turkey)
more common and severe in men overall
young adults (20-40)
cause of behcet’s?
possibly neutrophil hyperreactivity
not well understood
presentation of behcet’s?
classic triad:
recurrent aphthous-like ulcers
genital ulcers (painful; anus, vulva, scrotum)
anterior uveitis
others:
erythema nodosum
vascular: thrombophlebitis, DVT
ortho: arthritis
neuro: e.g. aseptic meningitis
GI: abdo pain, diarrhoea, colitis
how do oral ulcers in behcet’s differ to true aphthous ulcers?
larger + more painful + take weeks to heal (can be almost continuously present)
ix of bechet’s?
usually clinical (no definitive test)
pathergy test is suggestive (puncture site following needle prick becomes inflamed with small pustule forming within 48h)
mx of behcet’s?
orogenital ulcer: topical steroid
organ involvement: prednisolone + immunosuppressant (usually azathioprine)
what % of pt have a + FH of behcet’s?
30%
how does anterior uveitis present?
painful red eye + blurred vision
what is chancroid?
bacterial STI causing necrotising genital ulcers
(possible differential for behcets but doesn’t cause uveitis)
what is primary syphilis?
causes a single chancre (painless ulcer)
if untreated -> secondary syphilis causes multiple chancres with non-specific systemic features
(possible differential for behcets but ulcers are painless + no uveitis)
what HSR is Behcet’s?
type 3 HSR - immune complex deposition in small vessels
behcet flares may be precipitated by?
parvovirus
hsv
what dermatological symptom can be seen in behcet’s?
aphthous ulcers
genital ulcers
acne like lesions
erythema nodosum
