Case: A 17 Year Old Adolescent with Oral Ulcers and Arthritis of the Ankle

Background: Behсet’s disease is a rare rheumatologic condition characterized by recurrent oral and genital ulcers, rash, inflammatory eye disease, and vasculitis. It occurs worldwide, but its incidence is highest in the Far-East and Middle-East regions and in countries around the Mediterranean basin. Behсet’s disease usually starting during the third decade of life; this patient is 17-years of age.
Objective: The medical case of Behсet`s disease from the Pediatrics Department of Rostov State Medical University Clinic.

Methods: A 17-year-old adolescent was admitted to the hospital because of leg pain, weakness, sore throat, and oral ulcers. The patient had been well until 1,5-month before this admission when spotty-pustular elements appeared on his right leg. There were swelling and pain of the left ankle joint, pain in the left inguinal crease, gait disturbance. Spotty painless elements of bluish color on the left leg appeared. There were unpleasant sensations in the scrotum on the left and 3 black spots there. The body temperature increased to 39.5 °C, pain in the left thigh, left tibia increased, and rash increased in the scrotum area. The incorrect diagnosis was made: Erysipelas of the lower limb on the left. Lymphangitis. Ulcers of the scrotum of unknown etiology. Necrotizing vasculitis of the lower limb on the left.
In our clinic, Behcet’s disease was suspected. Clinical findings included asthenia, arthritis, pharyngitis, aphthous stomatitis, and the scrotum ulcers.

Conclusion: A diagnosis of Behcet’s disease was made on the basis of the recurrent oral and scrotum ulcers, arthritis, thrombosis of the iliac veins and deep veins of the lower extremity, enterocolitis. A pathergy test was negative. The results of diagnostic procedures included signs of inflammation (CRP - 36.0 mg/l, fibrinogen - 7.1 g/l, SFC - 10.0 g/l). No other manifestations of Behcet’s disease were present. The patient was treated with oral glucocorticoids, alkylating agents and anticoagulants about 6 months. The therapy was corrected every 2 months. Positive dynamics was observed: reduction of pain, extinction of the skin syndrome after the initiation of therapy.