Understanding Behçet's Disease Rash
“Behçet’s disease isn’t just painful — it’s isolating.
People don’t believe what they can’t see.”
GOAL
To educate and bring awareness to a disease often misdiagnosed
Illustration showing Behçet's disease skin manifestations like oral ulcers, genital sores, erythema nodosum, and papulopustular lesions with clear labels
THE SAD TRUTH
Why Behçet’s Disease Is Often Misdiagnosed
Behçet’s disease is commonly mistaken for other conditions due to its episodic nature and overlapping symptoms. It is frequently misdiagnosed as:
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Recurrent aphthous mouth ulcers
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Herpes simplex infections
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Acne or folliculitis
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Lupus or other autoimmune diseases
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Inflammatory bowel disease (IBD)
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Sexually transmitted infections (in cases of genital ulcers)
Because symptoms can appear gradually and flare intermittently, many patients see multiple specialists before receiving a correct diagnosis.
Diagnostic Approaches
There is no single definitive test for Behçet’s disease. Diagnosis is based on clinical criteria, medical history, and the exclusion of other conditions.
The Pathergy Test
The pathergy test is a supportive diagnostic tool. During the test, a small sterile needle prick is made in the skin, and the site is observed after 24–48 hours. The development of a red bump or pustule indicates an exaggerated inflammatory response, which is characteristic of Behçet’s disease in some patients.
CLINICIAN AWARENESS
Behçet’s disease is a multisystem inflammatory vasculitis that is frequently underrecognized and misdiagnosed, particularly outside of rheumatology and ophthalmology. The absence of a definitive diagnostic test, combined with episodic symptoms that affect different organ systems over time, often leads clinicians to treat symptoms in isolation rather than identify the underlying disease.
Because of its overlap with more common conditions, Behçet’s is commonly misdiagnosed as recurrent aphthous ulcers, herpes simplex infection, inflammatory bowel disease (especially Crohn’s), systemic lupus erythematosus, multiple sclerosis, fibromyalgia, or psychosomatic illness. Genital ulcers are often mistaken for HSV, neurologic involvement for MS, and gastrointestinal disease for Crohn’s, despite key distinguishing features.
Delayed or missed diagnosis can result in serious complications, including vision loss, neurologic damage, vascular events, and prolonged patient suffering. Increasing clinical awareness, recognizing symptom patterns, and considering Behçet’s earlier in patients with recurrent oral ulcers and systemic findings are essential to improving outcomes.
BECOMING AWARE
The global awareness of Behçet's syndrome
Behçet's syndrome is a systemic vasculitis (i.e vessel inflammation), potentially affecting all the organs of our body. New treatments are available for this rare condition, essentially based on anti-inflammatory drugs and immunosuppressants. The prevalence of the disease varies across countries, but generally speaking, being a rare disease, it affects by definition less than 5 in 10.000 people.
FACTS
Behçet’s disease (BD) is a rare, chronic inflammatory vasculitis with highly variable prevalence by region.
~5-7
years
Average timeline to diagnose the disease
~420 per
100,000 people
Turkey & Silk Road regions: very high prevalence
~11.9 per
100,000 people
East Asia: varied estimates
~0.3–5 per
100,000 people
Europe & U.S.: much lower prevalence
