title: Conjunctival ulcers in Behçet's disease.
abstract: OBJECTIVE
  To describe the occurrence of conjunctival ulcers as a manifestation of Behçet's disease.
  
  
  METHODS
  Retrospective, noncomparative, interventional case series with histopathologic correlation.
  
  
  METHODS
  Six patients who fulfilled the diagnostic criteria for Behçet's disease and presented with painful conjunctival ulcers were included in the study. Three of these ulcers were biopsied and studied histologically and immunohistochemically. The lesions were treated with topical or subconjunctival injection of corticosteroids and, in one case, with oral indomethacin.
  
  
  RESULTS
  Although all six patients fulfilled the diagnostic criteria for Behçet's disease, two developed uveitis and other signs of Behçet's disease only months to years after the appearance of the conjunctival ulcers. The 3- to 5-mm, round to oval ulcers were located in the limbal and/or bulbar conjunctiva. Histopathology revealed disrupted epithelium, infiltration of both acute and chronic inflammatory cells, and high endothelial venules. Immunohistochemical analysis of the infiltrating lymphocytes revealed primarily T-cell populations admixed with several B cells and CD68-positive histiocytes. After treatment, the conjunctival lesions invariably healed without scarring.
  
  
  CONCLUSIONS
  In addition to the oral and genital ulceration, ulcers can also be found in the conjunctiva of patients with Behçet's disease. Although this is a rare clinical sign, when accompanied by uveitis or orogenital ulcers, it may suggest a diagnosis of Behçet's disease.
authors.affiliation: Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, USA.
authors.forename: Ehud
authors.initials: E
authors.lastname: Zamir
authors.forename: Bahram
authors.initials: B
authors.lastname: Bodaghi
authors.forename: Ilknur
authors.initials: I
authors.lastname: Tugal-Tutkun
authors.forename: Robert F
authors.initials: RF
authors.lastname: See
authors.forename: Frederic
authors.initials: F
authors.lastname: Charlotte
authors.forename: Robert C
authors.initials: RC
authors.lastname: Wang
authors.forename: Bertrand
authors.initials: B
authors.lastname: Wechsler
authors.forename: Phuc
authors.initials: P
authors.lastname: LeHoang
authors.forename: Irene
authors.initials: I
authors.lastname: Anteby
authors.forename: Narsing A
authors.initials: NA
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D001402:B-Lymphocytes / Q000473:pathology; D001528:Behcet Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006644:Histiocytes / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019226:Oral Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D012883:Skin Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D013601:T-Lymphocytes / Q000473:pathology; D014456:Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D000097382:CD68 Molecule
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D005938:Glucocorticoids; D007213:Indomethacin; C067980:CD68 antigen, human; D000097382:CD68 Molecule