Behçet's ulcerations in the lower extremity: A case report

• Behçet's Disease is a systemic inflammatory disease which has organ and limb-threatening complications if treated improperly.
• We present a case review of a patient with un-diagnosed Behçet's Disease that had lower extremity ulcerations as a result of this disease.
• Our diagnosis and treatment protocols are outlined to show how we successfully managed this patient's ulcerations and disease.
• Guidelines for treating ulcerations secondary to Behçet's are outlined.

Behçet's Disease is a syndrome characterized by recurrent, painful oral aphthous ulcers, in conjunction with 2 or more systemic manifestations – a common systemic manifestation of the disease being cutaneous lesions, which often present as papules that ulcerate to form ulcerations which exhibit the same pathergy phenomenon as pyoderma gangrenosum and are thus difficult to heal. We present a case of a type 2 diabetic male with previously undiagnosed Behçet's Disease who presented to clinic with an atypical lower extremity wound. Due to the atypical nature of the patient's wound, combined with information from the patient regarding the history of the wound and other illnesses he had, the wound was biopsied and the results from the biopsy combined with clinical suspicion yielded a diagnosis of Behçet's Disease. After understanding the nature of the wound, management of the ulceration was adjusted appropriately so as to properly treat the patient with both local wound care and medical management for the disease. Patient was referred to rheumatology for further workup and long-term management of Behçet's Disease. Correct identification and treatment of the systemic disease, as well as the lower extremity ulcerations, in patients with Behçet's Disease are critical to avoid organ and limb-threatening complications. Had the diagnosis of Behçet's not been made in this case, the patient's wound would have been at increased risk of disease-related complications – ranging from non-healing ulceration leading to amputation to renal failure to loss of eyesight.