Severe Acute Genital Ulcer: An Unusual Presentation of Behçet’s Disease: A Case Report

Introduction: Genital ulcers are among the main manifestations of Behçet’s disease (BD); however, large severe acute genital ulcers are not common. Case Presentation: A 29-year-old unmarried woman with a history of recurrent oral aphthae presented with a genital ulcer developed 2 weeks before admission. On clinical examination, there were two large painful ulcerations on the right labia majora, painful oral ulcerations, non-follicular pustules on the face and limbs, and painful edema on the left leg with positive Homan’s sign. The D-dimer level was elevated, and a Doppler ultrasound showed deep venous thrombosis of the right common femoral, femoral, and popliteal veins. The BD was diagnosed according to the International Criteria for Behçet’s Disease. The patient was treated with prednisone 40 mg/day and colchicine 1 mg/day, and the lesions developed well and healed within 2 weeks, leaving scarring lesions in the genital area. Conclusions: Behçet's disease is an important nonvenereal cause of genital ulceration. A high index of suspicion in a patient with mucocutaneous lesions might result in the early diagnosis, management, and prevention of complications.