Abstract
Generally, the symptoms of Behçet’s disease (BD) start with oral aphthous ulceration, and BD characteristically develops into a systemic disorder including the muco-cutaneous, ocular, gastro-intestinal, vascular and neurologic organs. Although it is not so difficult to diagnose clinically typical cases, cases without aphthous ulceration can be more problematic. The diagnostic guidelines provided by the Japanese Research Group for BD organized by the Ministry of Health, Labor and Welfare suggests using a prick test with oral streptococcal antigens as a diagnostic method, because BD patients are generally hypersensitive to streptococci. However, it may be difficult to prepare standardized bacterial antigens for the diagnosis of BD. Therefore, we propose a much simpler diagnostic method, because the so-called “pathergy test” does not seem to be highly specific in BD. It is well known that the saliva of BD patients contains many oral streptococci, including uncommon serotypes of Streptococcus (S.) sanguinis and/or S. oralis. We performed prick tests with self-saliva and saline as controls on the forearm skin of 7 BD patients, 3 recurrent aphthosis (RA) patients, a herpetic oral ulcer patient, 2 non-BD erythema nodosum patients, and 5 healthy controls. Six of the 7 BD patients and one RA patient showed erythematous reactions (more than 10 mm in diameter) with a small pustule 48 hours after pricks with self-saliva. This self-saliva prick test seemed to have the potential to be as helpful in diagnosing BD as the one using streptococcal antigens.
