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Question 23#

A 32-year-old Japanese woman has a long history of recurrent aphthous oral ulcers. In the last 2 months she has had recurrent genital ulcers. She now presents with a red painful eye that was diagnosed as anterior uveitis. What is the most likely diagnosis?

A. Herpes simplex
B. HIV infection
C. Behçet disease
D. Diabetes mellitus
E. Systemic lupus erythematosus

Correct Answer is C

Comment:

This patient has classic Behçet disease, which occurs more commonly in Asians. Behçet disease is a multisystem disorder that usually presents with recurrent oral and genital ulcers. One-fourth of patients develop superficial or deep vein thrombophlebitis. Iritis, uveitis, and nondeforming arthritis are common. Blindness, aseptic meningitis, and CNS vasculitis may occur. Rare complications include pulmonary artery aneurysms and GI inflammation which may lead to perforation. Mucocutaneous lesions are usually treated with topical corticosteroids. Immunosuppressive therapy is recommended for patients with threatened blindness or central nervous system disease. The oral lesions of herpes simplex infection occur over the lips; anterior uveitis would be very uncommon. The mucocutaneous lesions of HIV infection are usually caused by Candida and are easily distinguishable from aphthous ulcers. Neither diabetes nor lupus would cause genital ulcers or anterior uveitis.