Recurring genital ulcers

Introduction Behcet's International Taxonomy: 1. Repeated oral ulcers: Observed by the physician or the patient is sure to complain of aphthous or herpetic ulcers, repeated 3 times in 1 year. 2. Repeated genital ulcers: observed by the physician or the patient affirmed that the genitals have aphthous ulcers or cramps, especially men. 3. Eye disease: uveitis (pre and/or post), cells visible in the vitreous during slit lamp examination, retinal vasculitis. 4. Skin lesions nodular erythematous lesions, pseudo folliculitis, purulent papules, acne-like rash (not seen with prednisone). 5. Positive acupuncture test: Take a small needle of sterile No. 20 needle and slant into the thorn skin. After 24 to 48 hours, the result is judged by the doctor. Anyone with repeated oral ulcers and more than 2 of the remaining 4 can diagnose the disease.

Cause

The cause of this disease is not clear according to the research, and is related to the following factors.

1 Infection: It has been reported that this disease is related to autoimmune abnormalities caused by acute or chronic viral infections such as streptococci and Mycobacterium tuberculosis infection. For example, according to domestic reports, one third of patients with this disease have suffered in the past. After tuberculosis or some patients with tuberculosis have been treated with tuberculosis, not only tuberculosis has been cured, but also the symptoms of Behcet's disease have improved. It has also been found that herpes simplex virus and hemolytic streptococcus are associated with this disease. Explain that bacterial viral infection is associated with this disease.

2 genetic factors: the disease has a regional incidence, such as more common in the Mediterranean countries. A study on HLA, a substance indicating human genetic characteristics, found that the positive rate of HLA-B5 in patients with Behcet's disease was over 60%, and the positive rate of HLA-B51 was also high. Therefore, it has been suggested that the genetic characteristics represented by these two HLA types may be the internal or internal environment of some Behcet's disease. Because not all patients with Behcet's disease have HLA-B5 or HLA-B51-positive Behcet may be related to autosomal recessive inheritance.

3 trace elements: the content of various trace elements in the diseased tissue of patients increased, such as organic chlorine, organic phosphorus and copper ions, some people also found that some trace elements of zinc, selenium deficiency, may be related to this disease.

4 immune abnormalities: anti-oral mucosal antibodies, anti-arterial wall antibodies and other autoantibodies in the serum, the positive rate of immune complexes in serum is 60% and related to the disease activity, the patient's immunoglobulin is increased, the proportion of lymphocytes is imbalanced around the blood vessels, Lymphocyte immunoglobulin, complement and other substances related to immune response can be seen in the lesions such as cerebrospinal fluid and blood vessel wall, indicating that the disease is closely related to immune disorders.

an examination

Related inspection

Thoracic CT examination of intrauterine bacterial culture

(A) Necessary conditions: recurrent oral ulcers; at least 3 ulcers or herpes-like ulcers were observed within one year.

(B) secondary conditions: (1) recurrent vulvar ulcers confirmed by the physician or the patient's own sure vulvar ulcers or scars. (2) Ophthalmitis: anterior and posterior uveitis or ophthalmologists use a slit lamp to detect vitreous, white blood cells, or retinal vasculitis. (3) Skin damage: Acne-like nodules that have been or have been used in the past or in the past for erythema or pseudo-hair follicles, or purulent papules, or those who have not used glucocorticoids and non-adolescents. (4) Those who are positive for acupuncture test. Others such as positive family history, arthritic joint pain, arteriovenous thrombosis, aneurysmal central nervous system disease, digestive tract ulcers, etc. should be considered whether it is related to this disease.

Differential diagnosis

1. Differential diagnosis of oral ulcers BD and recurrent aphthous herpes stomatitis are characterized by repeated oral ulcers, and the lesions are similar in shape, but the former involves multiple symptoms of multiple organs and multiple organs. The latter lesion is confined to the oral cavity.

2. Identification of multiple system lesions BD and clones of severe disease-synaptic syndrome, Reiter syndrome, etc. have multiple organ multi-system lesions, and have oral manifestations.

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