Aims: To describe the results of a study of the incidence of conjunctival ulceration and its pathology as a manifestation of Behcet's syndrome.
Methods: The authors reviewed retrospectively medical charts of 152 patients with Behcet's syndrome seen at the uveitis service of Okayama University Hospital from January 1995 to December 1999. Criteria used to diagnose Behcet's syndrome in this study required the presence of oral aphthous ulceration plus any two of three other manifestations-genital ulceration, eye lesions such as iridocyclitis uveoretinitis, or skin lesions such as erythema nodosum. The presence of conjunctival ulceration was determined in patients with Behcet's syndrome through standardised ophthalmological examinations. A biopsy of the conjunctival ulceration was performed in one patient. The incidence of conjunctival ulceration in patients with Behcet's syndrome was calculated and the clinical and pathological features of this ulceration were examined.
Results: Four of 152 patients (2.6%) developed conjunctival ulceration in concordance with exacerbation of their systemic symptoms. Histopathological examinations of a conjunctival biopsy specimen in one patient revealed intraepithelial and perivascular infiltration with neutrophils and lymphocytes consistent with Behcet's syndrome. The conjunctival ulcerations of the study patients showed good response to topical corticosteroids or topical steroids plus oral colchicine.
Conclusions: Conjunctival ulceration should be noted as an uncommon but possible manifestation of Behcet's syndrome. Accordingly, routine examination of the conjunctival is recommended in patients with Behcet's syndrome, and Behcet's syndrome should be included in a list of differential diagnoses for patients with conjunctival ulcerations.