EFFECT OF SURGICAL CLEANING OF THE SKIN ON THE PATHERGY PHENOMENON INBEHCETS-SYNDROME

Objectives-To assess the effect of surgical cleaning of the skin on th e pathergy phenomenon in Behcet's syndrome. Methods-The pathergy pheno menon was assessed in 183 patients with Behcet's syndrome in a single blind study at 48 hours after a needle prick of the forearm skin, clea ned in the conventional way with alcohol, with 10% povidone iodine, wi th 100% chlorhexidine, and with a 4% aqueous solution of chlorhexidine . Results-The surgical cleaning of the forearm with povidone iodine be fore the application of the needle prick reduced the prevalence of the pathergy reaction to 27% from 48% in the conventionally (by alcohol s wab) cleaned forearm. Cleaning the forearm with 100% chlorhexidine red uced the prevalence of the pathergy to 36% from 59% in the conventiona lly cleaned forearm. No significant changes were observed with a 4% aq ueous solution of chlorhexidine. Conclusions-Surgical cleaning of the skin with disinfectants of various concentrations reduces the prevalen ce of a positive pathergy test in Behcet's syndrome. This implies that more than the disruption of the structural integrity of the dermis an d epidermis is involved in the production of the pathergy phenomenon i n Behcet's syndrome.