Behcets disease is a rare, chronic disorder involving inflammation of blood vessels throughout the body. It is marked by recurrent oral and genital ulcers and eye inflammation.
The cause of Behcets disease is unknown. It is believed to be caused by an autoimmune reaction. This occurs when the body’s immune system attacks its own tissue by mistake. This autoimmune abnormality may be inherited. An environmental trigger, such as a specific virus or bacterium, may activate the disease in people susceptible to it.
Although the exact cause of Behcets disease is unknown, some groups of people are more likely to develop the condition than others. Behcets disease is more common in people who are 20-39. In the United States, men are more likely than women to develop Behcets. In the Middle East, Asia, and Japan, women are more likely than men to develop Behcets.
Factors that may increase your risk of Behcets include:
- Family history of Behcets disease
- A gene marker called the HLA-B51/B5 allele
Symptoms of Behcets disease can vary from mild to very severe. Symptoms tend to appear, heal, and then recur (referred to as a flare) frequently over months or years. The most common symptoms of the disease are:
- Affect almost all people with the disease
- Usually are the first to appear
- Usually last for 10-14 days
- Can be painful
- Can cause scarring
- In men: appear on the penis and/or scrotum
- In women: appear on the vulva or within the vagina
- Can be painful
- Can cause scarring
Uveitis—inflammation of the middle part of the eye, including the iris:
- Tends to cause eye redness, blurred vision, sensitivity to light, and watering eyes
- If not treated, can cause partial vision loss or blindness
—inflammation of joints:
- Tends to be painful
- Usually does not cause permanent joint damage
Skin problems, such as sores:
- May appear as red, raised sores or bumps, or may be flat (flush with the skin)
- Usually appear on the legs and upper torso
Complications of the disease may include:
- Severe fatigue during a flare
- Caused by thrombophlebitis (inflammation of veins), usually in the legs
- Can cause severe complications if not treated quickly
Aneurysms, or severely dilated blood vessels:
- May rupture and cause severe consequences
Heart problems, such as:
- Abnormal heart rhythms
- Missed heartbeats
- Early heartbeats
- Inflammation of the heart muscle ( myocarditis)
- Central nervous system problems:
- Causes ulcers and inflammation of the digestive tract (rarely)
Stroke from a Cerebral Aneurysm
Diagnosing Behcets disease is difficult because:
- Symptoms are similar to those of many other diseases.
- Symptoms often appear slowly, over months or years.
- There is no specific test to confirm the disease.
Behcets disease may be suspected if oral sores appear at least 3 times within a year and at least 2 of the following recurring symptoms appear:
- Eye inflammation
- Genital sores
- Skin sores
If Behcets disease is suspected, you may have a pathergy skin test. For this test, your skin is pricked with a small needle. If you have Behcets disease, a bump will develop at the site of the skin prick. However, this test is not conclusive. Many people with the disease do not have a reaction to the skin prick.
There is no cure for Behcets disease however, spontaneous regression may occur. Treatment is aimed at limiting and preventing complications from symptoms. With proper treatment, the disease can usually be managed fairly well. Treatment includes medications, rest, and exercise.
Both topical and oral medications are used.
Topical medications include creams, lotions, and mouth rinses that contain corticosteroids (to cut down on inflammation) and/or anesthetics (to decrease pain). These are applied to sores to reduce inflammation and pain.
Oral medications include:
- Oral corticosteroids—to reduce inflammation and pain
- Immunosuppressive drugs—to help control the overactive immune system
Many of the drugs used to treat Behcets disease can cause severe side effects. Your doctor must closely monitor you if you are taking these medications.
There are no guidelines for the prevention of Behcets disease because the exact cause is unknown.
American Behcets Disease Association
National Institute of Arthritis and Musculoskeletal and Skin Diseases
The Arthritis Society
Abu El Asrar, ABoooud EB, ALbibhi H, Al-Arfaj A. Long-term safety and efficacy of infliximab therapy in refractory uveitis due to Behcet's disease. Int Ophthalmol. Sep 23, 2006.
Behçet disease. Genetics Home Reference website. Available at: http://ghr.nlm.nih.gov/condition/behcet-disease. Updated July 2010. Accessed June 9, 2016.
Cakir O, Eren N, Ulka R, Nazaroghi H. Bilateral subclavian arterial aneurysm and ruptured abdominal aorta pseudoaneurysm in Behcet's disease. Ann Vasc Surg. 2002,16:516-520
Okada AA. Behcet's disease: general concepts and recent advances. Curr Opin Ophthalmol. 2006;17:551-556.
Last reviewed June 2016 by Michael Fucci, DO, FACC
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.