Pathology · patient case question
Which diagnosis best fits this combination of findings?
Patient case: Patient with oral ulceration and joint and node involvement
Patient: Adult presenting with recurrent oral ulceration
Chief complaint: Painful recurrent mouth ulcers.
Background: Reports joint swelling affecting the knees.
Current findings: Enlargement of the knees. Tender submandibular and anterior and posterior cervical lymphadenopathy.
Show answer and explanation
Correct answer: C. Behçet syndrome
- A. Lupus produces oral lesions and arthritis, but typically with a malar rash, photosensitivity and positive ANA.
- B. Crohn disease also produces oral ulceration and arthritis, but characteristically with cobblestoned mucosa, mucosal tags and gastrointestinal symptoms.
- C. BEHÇET SYNDROME is a systemic vasculitis defined by recurrent oral ulceration together with genital ulceration, ocular inflammation (uveitis) and skin lesions, and it commonly involves the joints. The oral ulcers are indistinguishable from major aphthae.
- D. Reactive arthritis gives the arthritis–urethritis–conjunctivitis triad with painless oral lesions.
Note: The source annotation links this to Sutton disease, the term for major aphthous ulceration — which is the morphology of the oral lesions in Behçet syndrome.