2019 Volume 65 Issue 3 Pages 194-198
We report a suspected case of intestinal Behçet’s disease diagnosed from a refractory oral ulcer. A 78-year-old man was referred to our department because of intractable ulceration of the oral cavity.
The ulcer was located in the mucosa of the left upper lip and measured 38 × 26 mm. No eye symptoms, skin manifestations, or vulvar ulcers were noted, and incisional biopsy revealed no malignancy. The ulcer finally contracted following 2 months of topical steroid administration; however, a month later, a new ulcer appeared on the right buccal mucosa.
We referred the patient to the department of gastrointestinal medicine to investigate the association between the intractable ulceration of the oral cavity and gastrointestinal disease. The patient underwent lower gastrointestinal tract endoscopy, which revealed multiple punched-out ulcers in the ileocecal region and large intestine. Accordingly, Crohn’s disease was ruled out; however, intestinal tuberculosis was not ruled out completely. Because the inflammation was mainly composed of neutrophils with no sign of infection on pathological examination, intestinal Behçet’s disease was suspected. Systemic administration of steroids was initiated; the ulcers in the oral cavity and ileocecum disappeared after 3 months. Long-term follow-up is necessary for ulcer recurrence.
