Behcet’s disease is a rare disease with painful mouth and genital ulcers, along with eye, skin and other problems. The cause is thought to be immune. This is rare in the UK but occurs in about 1 in 10 000 people living in the Mediterranean basin, Middle and Far East.

Mouth ulcers are the most common sign of Behcet disease. The other common signs are ulcers on the genitalia, eye changes, lumps on the shins and acne type spots.  Sore throats, loss of weight, aches and pains, fatigue, headache and a feeling of hot or cold, can occur.

Less commonly, arthritis, gastrointestinal (e.g. abdominal pain, diarrhoea, vomiting), nervous system and circulation problems can occur. It can be difficult to diagnose as symptoms come and go.
Criteria for the classification of Behcet’s disease include at least 3 episodes of recurrent oral ulcers in a 12-month period plus at least two of the following:

• Genital ulcers
• Eye involvement (uveitis or retinal damage)
• Skin lesions
• Pathergy (this is a skin prick test)
• Patient Information
• Behcet’s disease atient.co.uk:  http://www.patient.co.uk/doctor/Behcet%27s-Disease.htm
• NHS Choices:  http://www.nhs.uk/conditions/Behcets-disease/Pages/introduction.aspx
• DermNet NZ: http://dermnetnz.org/systemic/behcet.html

Do I need any tests?

• A biopsy of a genital ulcer may be done to confirm the diagnosis.
• Blood tests will also be done.

Treatment
Currently, as there is no cure, management is to control symptoms and try and prevent complications.

The genital ulcers are helped by a hygiene regime that does not irritate as harsh washing and cleansing of the vulva can make it more dry, irritated, sore and itchy.
For advice on caring for the vulval area:
Care Down There http://www.caredownthere.com.au/_pages/information_care.html
International Society for the Study of Vulvovaginal Disease: Mike can you make sure this link is to the PDF the ISSVD supplied
British Association of Dermatologists: http://www.bad.org.uk/Portals/_Bad/Patient%20Information%20Leaflets%20(PILs)/Care%20of%20Vulval%20Skin%20Mar%202009.pdf

Specific treatments
Treatment includes creams, gels and tablets, such as immunosuppressants (oral steroids, azathioprine), colchicine, dapsone and other drugs.

Treatment guidelines and information
Emedicine:  http://emedicine.medscape.com/article/1122381-overview
Medline Plus:  http://www.nlm.nih.gov/medlineplus/behcetssyndrome.html

Some approaches to treatment have been reviewed for the Cochrane Library:
Pharmacotherapy for Behcet's syndrome
http://www2.cochrane.org/reviews/en/ab001084.html
Patient support groups
UK National Patient support group:  http://www.behcets.org.uk/