Bechet’s Disease and its association with Herpes Simplex Virus : Case Report of a rare Multisystem disorder with review of the literature

Abstract

In the year 1937, A Turkish dermatologist Prof Hulusi Bechet described a syndrome based upon three cases. His first reported case in the year 1924 was a female who presented with recurrent aphthous ulcers of the oral cavity, genital ulcers, erythema nodosum and visual impairment which later lead to blindness. The second patient presented in 1930 with oro-genital ulcerations and scleral injection in the eyes. The third case was reported in the year 1936, a male which similar complaints, scrotal ulcers, loss of vision, scleral injection, fever and myalgia. Professor Hulusi Bechet grouped these clinical findings into a syndrome known as Bechet’s syndrome. Bechet's disease may present in several ways, and many patients' oral ulcers are the presenting complaints. Oral ulcers are usually underdiagnosed and often ignored by the patients. Later on, genital ulcers and complications such as Uveitis appear, which cause the patients to seek medical help. This is a rare disorder, but it must be considered as the complications may lead to a permanent impairment of vision.In many cases and studies, Bechet's disease is associated with the Herpes simplex virus. The evidence that we report is also found to have positive antibodies for Herpes simplex virus. Herpes Simplex Virus is a DNA Virus and is a causative agent in various ocular diseases such as conjunctivitis, corneal ulceration, stromal keratitis, scleritis iridocyclitis, Uveitis. On an average HSV Uveitis occurs at the age of 46 years. Herpetic corneal ulceration is a cause of blindness in these patients. Bechet's disease is also associated with Uveitis and has a dreaded complication of blindness. The patient that we report had both oral ulceration, genital ulceration, Uveitis and was found to have HSV antibodies. Management and treatment must reduce relapses.