(Last Updated On: October 30, 2018)

Authors: Felina Joyce Posadas Dy, MD; Marian Caligayahan, MD; Cynthia Tan, MD, FPDS


Introduction: Behcet’s disease has been described to be both an autoimmune and an autoinflammarotory disorder. Recurrent oral aphthous ulcers characterize this disease, usually with the involvement of other organ systems including dermatologic manifestations. Due to its ability to involve blood vessels, vasculitis is the usual finding. It is vital for dermatologists to diagnose this disease among patients who are coming in with a primary skin complaint in order to avoid missing out on the possibility of fatal complications such as a pulmonary artery aneurysm.

Case Summary: We report a case of a 46-year-old female who presented with a 4-year history of recurrent erythematous tender nodules on the anterior and posterior aspects of her lower legs, intermittently associated with painful tongue ulcers, easy fatigability and undocumented fever. She reported a singular event of vulvar ulceration in the previous years, but had normal genital findings on physical examination. A battery of laboratory tests was done revealing unremarkable results. Skin punch biopsy with hematoxylin and eosin stain showed septal panniculitis with focal vasculitis. Patient was treated with Methotrexate 10mg/week with good response, and a multidisciplinary approach was instituted.

Conclusion: Behcet’s disease, though uncommon, should be considered in those patients who present with recurrent oral ulcers and seemingly unrelated abnormal findings in other organ systems, such as the skin and genitals. The importance of a thorough clinical history, physical examination and a high index of suspicion are essential in the diagnosis of this disease and the subsequent prevention of fatal complications





Behcet’s syndrome, Behcet’s Disease, Erythema nodosum in Behcet’s

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