Behcet syndrome: a case report and therapeutic strategies.

Behcet syndrome is a multisystemic disorder that typically presents with oral and genital ulcerations as well as ocular involvement. We are describing a severe case of a client presenting with aphthous ulcers, conjunctivitis and severe uveitis, and refractory genital ulcerations. The clinical presentation in this client fulfills both the international and O'Duffy criteria for the diagnosis of Behcet syndrome. Oral biopsy did not prove to be conclusive however, shave specimens from the scrotal and penile lesions did prove to reveal vasculitic changes however failed to reveal any overt vasculitis distant to the ulcerations. The uveitis was quite severe, failing to respond to topical/ophthalmic drops. The left eye in fact required subtenon injection of triamcinolone (Kenalog) due to the progressive nature and severity of this client's uveitis. The response was excellent with a complete visual recovery. Colchicine therapy was instituted as well with oral lesions subsiding relatively quickly, however, scrotal and penile lesions required a more prolonged course of therapy. The case was discussed and literature reviewed. Clinical diagnosis of the syndrome and aggressive forms of treatment regimes are suggested.

Luiz Nascimento, MD, Layla Mabe, ANP, Anna Fakadej, MD, Julie Morley, PAC, and David Klumpar, MD. Sandhills Medical Group, Carolina Eye Associates, Carolina Skin Care, Hamlet, NC.