Clinical cases
Herpes Simplex - Trigger factor for Bechet disease

Introduction: Behcet’s disease is a multisystemic
inflammatory condition, with unknown etiology. Most
common clinical manifestations include painful oral
mucosa ulcerations, painful genital mucosa ulcerations,
cutaneous lesions and ocular lesions. Positive HLA-B51
antigen is a well-known risk factor. The etiopathogenesis of
the disease includes bacterial, viral and environmental
Case report: We report the case of a 24-year-old
female patient, from urban area, who presented to our clinic
for painful polymorphic cutaneo-mucosal lesions. Skin
assessment revealed multiple painful oral and genital
mucosa ulcerations, as well as upper chest pustules and
pretybial bilateral subcutaneous nodules. Ophtalmological
examination identified conjunctival hyperemia, right
palpebral edema and photophobia. Laboratory findings
revealed leukocytosis with neutrophilia, elevated erythrocite
sedimentation rate (ESR) and positive rheumatoid factor
(FR). Bacteriological and micological tests performed from
the lesions were negative. Serological tests were performed
and IgM anti herpes simplex virus type 1 (Ig M anti HSV-
1) and IgM anti herpes simplex virus type 2 (IgM anti
HSV-2) were identified. The patient followed systemic
treatment with nonsteroidal anti-inflammatory drugs
(NSAIDs) and local treatment with a combination of
steroidal and antibiotic cream. Clinical evolution was
favorable, with complete resolution of lesions in
approximatively 1 week.

Conclusions: The possible viral etiology of Behcet’s
disease is a long investigated topic. Complete evaluation
and multidisciplinary follow-up of these patients is vital in
the approach of these cases.