Behcet's disease is a syndrome characterized by oral and genital ulcers and uveitis, which can affect the skin, joints, gastrointestinal tract, cardiovascular system, central nervous system, lungs, and other organs. The cause of the disease is unknown, and its onset may be related to autoimmune reactions triggered by chronic viral infections, streptococcal infections, or subcutaneous nodular infections. This condition is more common in young and middle-aged adults.

bubble_chart Clinical Manifestations

1. Oral ulcer: Can occur in various parts of the oral cavity such as the tongue, lips, and gums, and may also affect the pharynx, larynx, esophagus, and nasal cavity. The lesion begins as a small round or irregular nodule, rapidly forming a painful ulcer with yellow necrotic material at the base and surrounded by a red halo. It can heal spontaneously within 1–2 weeks but is prone to recurrence.
2. Genital ulcer: Similar in appearance to oral ulcers but occurs after oral ulcers and involves deeper lesions. Commonly found on the external genitalia of both sexes, it may also affect the cervix, vagina, labia majora/minora, penis, glans, scrotum, perineum, and anorectal regions.
3. Ocular lesions: 90% of patients experience eye involvement, usually occurring later in the course. Manifestations include anterior/posterior uveitis, hypopyon, iridocyclitis, conjunctivitis, scleritis, keratitis, vitreous hemorrhage, and optic neuritis. Severe cases may lead to glaucoma, internal visual obstruction, or even blindness.
4. Skin lesions: 40-80% show a positive pathergy test (positive within 24–48 hours after needle prick and unexplained by other clinical conditions). Other skin manifestations include erythema nodosum, pseudofolliculitis, papules, pustules, or post-adolescent acne-like nodules in patients not treated with corticosteroids.
5. Arthritis: Polyarticular and migratory arthritis affecting large joints such as the wrists, knees, elbows, and ankles.
6. Visceral involvement: May present as vasculitis affecting the nervous system, heart, lungs, kidneys, and gastrointestinal tract, involving medium to large blood vessels.
7. Systemic symptoms: Fever, fatigue, loss of appetite, weight loss, etc. Diagnosis can be made if the first criterion is met along with two other criteria.

bubble_chart Diagnosis

1. Recurrent painful oral ulcers, or ulcers or vesicle-like ulcers observed by the patient, recurring at least three times within a year, and meeting two of the following criteria:
2. Recurrent genital ulcers, observed by a physician or the patient, or scars formed due to ulcers;
3. Eye lesions: anterior or posterior uveitis, vitreous hemorrhage observed under slit-lamp examination, or retinal vasculitis;
4. Skin lesions: erythema nodosum, pseudofolliculitis, papules, pustules, or acne-like nodules post-adolescence, in patients not treated with corticosteroids;
5. Positive skin pathergy test: positive within 24–48 hours after needle pricking, with no other clinical explanation.

bubble_chart Treatment Measures

Principles of Treatment

1. Avoid various inducing factors, maintain a regular lifestyle, and ensure appropriate rest and activity;
2. Use vasodilators to improve blood supply and promote the establishment of collateral circulation;
3. Provide symptomatic treatment, such as analgesia, anti-infection, and anti-tuberculosis therapy;
4. Supportive therapy;
5. Local ulcer treatment.

Principles of Medication

1. Root Leaf or Flower of Common Threewingnut, colchicine, or thalidomide are particularly effective for oral ulcers;
2. Use corticosteroids, reduce the dosage after control is achieved, and discontinue after complete remission;
3. For accompanying vasculitis or vascular embolism, add non-steroidal anti-inflammatory drugs, microcirculation-improving agents, anticoagulants, and fibrinolytic drugs such as Salvia preparations, dipyridamole, stanozolol, aspirin, etc.;
4. For cases with stirred pulse tumor diseases, early surgical treatment is recommended;
5. For ocular fundus damage, in addition to high-dose vitamin E as in examination frame "A," options from examination frames "B" and "C" may be selected, such as cyclosporine;
6. For local ulcers or superficial vasculitis, physiotherapy, air negative ion therapy, and ultrasound therapy can be applied;
7. For refractory lower limb nodules, Cinnamon Twig and Poria Pill has shown good efficacy.

bubble_chart Cure Criteria

1. Healing: Oral and genital ulcers healed, skin lesions and symptoms disappeared, laboratory tests returned to normal;
2. Improvement: Most symptoms disappeared, skin lesions subsided, ulcers significantly improved, laboratory tests trending toward normal;
3. Symptoms and skin lesions subsided, <50%潰瘍未癒，實驗室檢查異常。