Conjunctival ulcers in Behçet's disease.
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.
Zamir
Ehud
E
Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, USA.
Bodaghi
Bahram
B
Tugal-Tutkun
Ilknur
I
See
Robert F
RF
Charlotte
Frederic
F
Wang
Robert C
RC
Wechsler
Bertrand
B
LeHoang
Phuc
P
Anteby
Irene
I
Rao
Narsing A
NA
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
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D005938:Glucocorticoids; D007213:Indomethacin; C067980:CD68 antigen, human; D000097382:CD68 Molecule