Someone who has Behcet’s disease will usually begin to have symptoms between 20 and 30 years of age.
Behcet’s disease can cause a wide range of symptoms, but it is uncommon for someone with the condition to experience all of the possible symptoms. These are outlined below.
Almost all people with Behcet’s disease have repeated episides of painful mouth ulcers.
The ulcers tend to develop on the tongue, lips, gums and the inside of the cheek. They usually heal within 10 days, although they often return.
Like mouth ulcers, genital ulcers are also a common symptom of Behcet’s disease, occurring in an estimated 72-94% of cases.
In men, the ulcers usually appear on the scrotum, while in women they appear on the cervix, vulva or vagina. However, genital ulcers can appear anywhere in the groin region, including on the penis.
The genital ulcers are usually painful and can leave scarring. Men may also experience inflammation or swelling of the testicles, while women may find that the ulcers make sex painful.
Genital ulcers that are caused by Behcet’s disease are not contagious and cannot be spread through sexual intercourse.
Inflammation of the eyes is another common symptom of Behcet’s disease, occurring in an estimated 30% of cases.
Inflammation usually affects the uveal tract. The uveal tract is a group of connected structures inside the eye, made up of the iris (the coloured part of the eye), the ciliary body (the ring of muscle behind the iris), and the choroid (the layer of tissue that supports the retina). Inflammation of the uveal is known as uveitis.
The symptoms of uveitis can cause:
- painful, red eyes,
- sensitivity to light (photophobia),
- floaters (dots that move across the field of vision), and
- blurred vision.
See the ‘useful links' section for more information about uveitis.
In the most severe cases of Behcet’s disease, inflammation of the eyes can lead to a permanent loss of vision. However, this is now far less likely if you are receiving treatment with immunosuppressants.
Around 80% of people with Behcet’s disease will develop skin lesions, usually on their lower limbs.
Outbreaks of acne, much like teenage acne, are also common. Skin lesions and patches of acne should heal within 14 days, but they may frequently reoccur.
Around two thirds of people with Behcet’s disease will experience inflammation and swelling in their joints. The knees, ankles and wrists are often affected. The inflammation and swelling can produce arthritis-like symptoms, such as stiffness and pain, in the affected joints.
Pathergy (over-sensitive skin)
Pathergy is a term that is used to describe skin that is particularly sensitive to injury or irritation. For example, if a needle is used to prick the skin of someone who has pathergy, it would result in a large red bump that appears to be an over-sensitive reaction.
Pathergy is more common among people of Middle Eastern origin, and less common in Asian and white people.
Vascular disease (inflammation of the veins and arteries)
Inflammation of the veins and arteries occurs in a minority of people with Behcet’s disease. It produces redness, pain and swelling in the limbs.
In the most severe cases of vascular disease, the inflammation of the veins and arteries can result in serious and possibly life-threatening complications. The complications can include:
- deep vein thrombosis (DVT) - a blood clot in the leg,
- aneurysms - swelling of an artery, and
- pericarditis - swelling of the lining of the heart.
See the ‘useful links' section for more information about these three conditions.
Gastrointestinal disease (inflammation of the stomach and intestine)
Inflammation of the stomach and intestine occurs most frequently in people of Japanese origin. The inflammation can cause symptoms such as:
- loss of appetite,
- diarrhoea, and
- abdominal pain.
Inflammation of the nervous system
Inflammation of the central nervous system (CNS) is the most serious type of symptom associated with Behcet’s disease.
CNS inflammation occurs in an estimated 5-10% of cases of Behcet’s disease, usually within five years of the initial onset of symptoms.
The symptoms of CNS are most common in men. The inflammation usually develops quickly, over the space of a few days. Symptoms can include:
- uncontrollable twitching or shaking,
- partial paralysis on one side of the body,
- changes in behaviour - people become either unusually apathetic or unusually uninhibited, and
- loss of bowel and bladder control.