Mucosal features of Behçet syndrome

Recurrent painful oral and genital ulcers (aphthae) are the most common clinical features of Behçet syndrome. Oral aphthae (or canker sores) are round and range in size from a few millimetres to 2 centimetres. They mostly appear on the mucosae of the cheeks, lips, tongue and gingivaYazici, 2021 and are nonscarring. Genital aphthae are similar in appearance to oral aphthae and most commonly occur on the scrotum in males and the vulva in females. Genital ulcers commonly result in scarring.

Herpes simplex virus (HSV) infection is a differential diagnosis for recurrent Behçet syndrome; ulcers caused by HSV cannot easily be differentiated from those associated with Behçet syndrome without microbiological testing. As the treatment differs for HSV and Behçet syndrome, always consider coexistent HSV infection in people presenting with oral or genital ulceration, even if a recurrent episode of Behçet syndrome is likely.

Note: Always consider coexistent HSV infection in people with oral or genital ulceration, even if a recurrent episode of Behçet syndrome is likely.

If HSV infection is suspected, see Herpes simplex virus infections for diagnosis and management.