Genital aphthosis in Behçet’s disease: Is it associated with less eye involvement?

Abstract

Behçet's disease (BD) is a multisystem disease classified among the vasculitides with various clinical features. Genital aphthosis (GA) is one of the major manifestations of BD. The aim of this study was to evaluate the characteristics of BD patients with GA. A cross-sectional sample of BD patients registered in 37 years was selected. We determined clinical and laboratory features of BD patients with GA (GA cases) and compared them with the patients who never developed GA (non-GA cases). The comparisons were performed by the chi-square test and logistic regression analysis. Odds ratios (ORs) with 95 % confidence intervals were calculated to estimate the precision of ORs. Among 6,935 BD patients, 4,489 cases (64.7 %) were ascribed to GA cases. Male to female ratio (1.11:1.00 vs. 1.48:1.00 OR 0.753, P value <0.001) and mean age of disease onset (OR = 0.9, P value <0.001) were lower in GA subset. In GA cases, oral aphthosis (OA) was a more common onset manifestation (OR 2.250, P value <0.001), while uveitis (OR 0.140, P value <0.001) and retinal vasculitis (OR 0.077, P value <0.001) were less common at the disease onset. In the whole course of disease, eye involvement was less common in GA cases (OR 0.215, P value <0.001). On the contrary, OA (OR 19.698, P value <0.001), skin (OR 1.762, P value <0.001), joint (OR 1.257, P value = 0.001), gastrointestinal (OR 1.302, P value = 0.009), neurological (OR 1.624, P value <0.001) and vascular involvements (OR 1.362, P value <0.001), epididymitis (OR 1.596, P value <0.001), positive pathergy test (OR 1.209, P value <0.001) and positive familial history of OA (OR 1.325, P value <0.001) were more common in GA subset. This study showed that GA subset of BD is associated with less eye involvement but higher rates of other BD manifestations.

Genital ulcer severity score and genital health quality of life in Behçet’s disease

“…Genital ulcers are less common in males and are found most frequently on the scrotum. The frequent occurrence of genital ulcers in adults between 20 to 40 years may be related to a combination of environmental and hormonal factors [ 5 ]. Most of the genital ulcers in females were herpetiform in morphology, although minor and major aphthous ulcers also occur.…”

“…BD is characterised by recurrent mucocutaneous lesions [ 4 ]. Oro-genital ulcers are usually the first sign and the main classification criteria of BD patients [ 5 ]. Skin lesions, relapsing uveitis, and articular, neurologic, urologic, intestinal and pulmonary manifestations can cause serious disability and significant impairment in the quality of life [ 6 ].…”

Mucocutaneous Findings in Behçet’s Disease

“…They compared clinical and laboratory features between the patients with GU and patients who never developed GU (non-GU cases). As a result of their study, OU and other cutaneous manifestations such as pseudofolliculitis and erythema nodosum were found to be higher while eye involvement was found to be less common in the GU group [46]. Behcet's Disease 74…”

“…Genital ulcers (GUs) are generally the second most frequent disease manifestation [2,9,21,26,28,45,46]. GUs are observed in approximately 60-97% of the patients with BD at any time of the course of the disease [4,19,21,22,28,36,43,47].…”

Does obesity prevent occurrence of genital ulcers in women with Behçet’s disease? A striking observation in 17 consecutive patients

“…It is more common in women and younger patients. As a hypothesis, thin mucocutaneous tissue in women compared with men may result in this difference 1,2 . Sexual activity of younger patients may also contribute to the formation of genital ulcers.…”