Recurrent aphthous stomatitis in Behcet's disease: clinical features and correlation with systemic disease expression and severity

Behcet's disease (BD) is a multisystem disease, in which recurrent aphthous stomatitis (RAS) is a universal finding. We studied the expression of RAS in patients with BD, and the correlation between major or minor RAS and sys temic expression and severity of the disease. Thirty-five patients with ED were studied, of whom 13 (37%) had major, 21 (60%) had minor and one (3%) h ad herpetiform RAS. The frequency of major RAS was significantly higher com pared with a control group of patients with idiopathic RAS (37% vs 9%, P<0. 05). The ED patients with major RAS had significantly more relapses of oral ulceration in a year, higher numbers of oral ulcers per relapse, and longe r duration of aphthous episodes, compared with patients with minor RAS. Ora l ulcers also appeared at a significantly younger age in patients with majo r than with minor RAS. However, the systemic expression of the disease, as well as the disease severity score, were similar in patients with major and minor RAS. The results of this study indicate that major RAS is common in patients with ED, and is associated with a more severe, repeated and prolon ged oral disease. Nevertheless, the presence of major RAS in ED does not pr edict a more severe systemic illness.