What are the symptoms of Behcet's disease?

Behcet's disease is actually a common disease. The characteristics of this disease are also relatively obvious, because its symptoms will appear in the eyes, mouth and genitals, causing extreme discomfort to patients. The more obvious symptoms of Behcet's disease are oral ulcers, vulvar ulcers, eye inflammation, etc. These symptoms have a great impact on the patient's daily life.

Behcet's disease, also known as Behcet's syndrome and oral-ocular-genital triad, is a disease that occurs simultaneously in the mouth, eyes, and genitals. Those with two of these symptoms are considered to have the incomplete type. This disease is an autoimmune disease, a chronic, progressive, recurrent, multi-system damaging disease with small vasculitis of unknown cause as the pathological basis.

Mouth ulcers

The ulcers are usually sharp-edged, painful, and located on the lips, gums, tongue, or cheek mucosa. The ulcer is round or oval in shape, with a white or yellow pseudomembrane on the surface. It is often multiple and usually heals after 1 to 2 weeks, but it may recur. Some patients have persistent ulcers that do not heal, affecting their appetite. Almost all patients develop oral ulcers.

Genital ulcers

It often occurs in the scrotum, glans penis, female labia, vaginal wall, and even cervix and urethra. The ulcer morphology is similar to that of oral ulcers, but the recurrence rate is not as strong as that of oral ulcers. Physical examination may reveal vulvar ulcers or scars after ulcer healing.

Eye inflammation

Early symptoms include conjunctivitis and iridocyclitis, and later symptoms include hypopyon, uveitis, and conjunctival, corneal, and retinal hemorrhage. Eye inflammation is rarely the first symptom of this disease. It usually occurs several years after the mouth ulcer first appears. Symptoms include eye and periorbital pain, photophobia, pupil deformation, and affected vision on one or both sides. This disease is the leading cause of blindness in Japan. Hemorrhage, arteriovenous occlusion, and optic nerve atrophy may be seen in the fundus.

Skin symptoms

Most of them are erythema nodosum and erythema multiforme, folliculitis, acne-like rash and skin allergies. The acupuncture test (Pathergytest) uses a 20-gauge or smaller needle to pierce the skin obliquely under sterile conditions. If pustules or folliculitis appear at the puncture site 24 to 48 hours later, and there is a red halo around the puncture site, it is positive. The positive rate among patients in Japan and Türkiye was 90%, and among patients in China it was 62.2%. The test has high specificity and rarely shows positive results in other diseases or normal people.

Joint manifestations

50% to 60% of patients complain of joint pain, and acute or chronic synovitis may occur, but joint redness, swelling and bone destruction are rare. The large joints of the limbs, especially the knees, are most often affected.

Central nervous system manifestations

10% to 18% of patients suffer from damage to the central nervous system. There may be headache, neck stiffness, meningitis, epilepsy, flaccid paralysis, sensory and movement disorders, cerebellar ataxia, cranial nerve damage and various psychiatric symptoms. Involvement of the central nervous system often indicates a serious condition and a poor prognosis.