A 30-year old woman from Turkey presents for further evaluation after a recent visit to a family physician showed multiple mucocutaneous ulcers. These ulcers have been a recurrent problem for her, she says. She admits to much pain due to these ulcers. She also presents with genital ulcerations and cutaneous legions.
She admits to recently visiting an ophthalmologist due to uveitis as well, and is still undergoing treatment for it. She has also been evaluated for both parenchymal and non-parenchymal disease, but the tests came back negative. The patient is single, and has never been pregnant nor is pregnant right now.
Recent evaluation included a CBC with diff. LFT’s. Immunoglobulins, CPK, and UA were all normal. ESR was elevated, and TB was negative. Her physical examination is remarkable for white-colored legions within her mouth, as well as yellow-colored legions along her vulva and skin. The uvea of her eye is also inflamed.
At the time, you would recommend starting treatment with:
A: Glucocorticoids
B: Etanercept
C: Colchicine
D: A and B
E: All of the above
The correct answer is D: A and B. For this patient, the glucocorticoids would be beneficial in treating the patients’ uveitis. Etanercept would also be useful in treating the ulcers and legions on the patient’s skin and genitals and within her mouth. Colchicine is used on many patients with Behcet’s Disease who have arthritic symptoms, but she does not present with any.