Differentials
Aphthous stomatitis (recurrent)
SIGNS / SYMPTOMS
Only oral ulcers, none of the other manifestations.
INVESTIGATIONS
None.
Crohn disease
SIGNS / SYMPTOMS
Genital ulcers and eye involvement less common.
Rectal or anal pathology more common.
INVESTIGATIONS
Colonoscopy and biopsy show Crohn disease findings.
It may be difficult to differentiate Behcet syndrome from Crohn disease.
Ulcerative colitis
SIGNS / SYMPTOMS
Genital ulcers and eye involvement less common.
Rectal or anal pathology more common.
INVESTIGATIONS
Colonoscopy and biopsy consistent with ulcerative colitis.
Herpes simplex infection
SIGNS / SYMPTOMS
Oral ulcers may be on the outer part of the lips, not just the mucosal surface.
INVESTIGATIONS
Cultures and serology for herpes are positive.
Necrotizing vasculitis
SIGNS / SYMPTOMS
Renal and lung vasculitic involvement possible, unlike Behcet syndrome.
INVESTIGATIONS
Presence of antineutrophil cytoplasmic antibodies in some patients.
Seronegative spondyloarthropathies
SIGNS / SYMPTOMS
Psoriasis, sacroiliac involvement, and penile lesions possible.
INVESTIGATIONS
HLA-B27 associated.
Acne vulgaris
SIGNS / SYMPTOMS
Distribution of lesions less facial and more truncal and on limbs.
INVESTIGATIONS
None.
Erythema nodosum
SIGNS / SYMPTOMS
Nodular lesions on limbs, self-resolving, may be painful. No oral or genital ulcers.
INVESTIGATIONS
None. Behcet syndrome is a cause of erythema nodosum.
Superficial thrombophlebitis
SIGNS / SYMPTOMS
No oral or genital ulcers.
INVESTIGATIONS
Duplex ultrasound reveals noncompressible vessel. Behcet syndrome is a cause of superficial thrombophlebitis.
Rheumatoid arthritis
SIGNS / SYMPTOMS
Mucocutaneous ulcers should be absent.
INVESTIGATIONS
Rheumatoid factor positive.
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