This post has been self-published on Youth Ki Awaaz by Sukant Khurana. Just like them, anyone can publish on Youth Ki Awaaz.

Can common mouth ulcers be more dangerous, even Behçet’ s Disease?

More from Sukant Khurana


By Maria Razzaq, Farooq Ali Khan, Abhishek Kumar, Raamesh Gowri Raghavan, and Sukant Khurana*

What if the mouth ulcer you ignored was not an ordinary but a symptom of something worse? Mouth ulcers and Uveitis are the most common early manifestations of Behçet Disease.

An inflammation of the blood vessels, Behçet Disease was first described by a Turkish doctor and scientist, Hulusi Behçet (1937) after observing them in a patient in 1924.

§ Classification — It can be classified as a mucocutaneous and arthritic disease.

§ Symptoms — It is characterized by a triple symptom disorder including recurrent apthous ulcers, genital sores and uveitis.

o Mouth — The symptoms can range from sores to ulcers.

o Skin — It involves acne -like sores or tender raised nodules on the epithelial surface.

o Genitals — Red open sores on the scrotum or the vulva.

o Eyes — Inflammation of the Uvea (Uveitis).

o Other symptoms include Joint swelling in knees and pain; Diarrhea, abdominal inflammation.

o Brain and Nervous System — It can vary from headaches, fever to disorientation, memory loss and hemorrhages.

§ Etiology –

No exact cause has been yet described; it is considered as an autoimmune disorder which can be triggered by various environmental factors or/and virus, bacteria (Streptococcus) etc. It can also be caused by immune complexes that lead to the inflammation of small and medium sized blood vessels and strong association with certain HLA type. Some scholars suggest the cause to be the inflammation of epithelial cells caused by immuno -competent T-lymphocytes and plasma cells. Several genetic and environmental factors can also be associated with its development.

§ Epidemiology –

More cases have been found in Middle east and far eastern countries like Turkey, Japan, China etc. It’s occurrence is found to be highest along the old silk route from Middle east to china.

§ Risk Factors –

o It has been diagnosed mainly in the people in their 20s and 30s

o This condition is more severe in males.

o In Germany, Japan, and Brazil, the disease is slightly more common in females. Behçet disease is more common in females with the ratio of 5:1 in the United States of America.

o Certain people carry the risk factors in their genes.

§ Complications –

o Severe uveitis can lead to blindness.

o Neurological complications can cause memory deficits and loss of brain function.

o Pulmonary and arterial aneurysms coupled with Behçet disease, if ruptured have a high mortality rate.

o Vasculitis and Thrombosis are one of the major causes leading to the death of an individual.

§ Diagnosis –

o Mouth sores — have to be recurrent (at least thrice in a year)

o Genital sores

o Eye inflammation

o Skin Sores

o Positive Pathergy Test

o Any two symptoms apart from mouth sores conclude the diagnosis of Behçet disease.

§ Misdiagnosis –

o Mouth sores can however be easily mistaken for Canker Sores but they differ in a great deal. Canker Sores are less than 1mm in diameter and heal without scarring however this is not the case in these ulcers which are apthous in nature and larger as well as heal with scarring.

o These sores can also be mistaken for herpetic sores; however they are quite different in appearance — They occur singly while that of herpes are found in clusters.

§ Cure –

o Since it’s an autoimmune disorder, no exact cure exists; only symptomatic treatment can be given.

o In early stages, Corticosteroids containing skin creams, gel, ointments, mouth rinses, eye drops are given to treat the sores and inflammation. Side effects include weight gain, persistent heartburn, high blood pressure and osteoporosis.

o Colchicine (Colcrys) is said to improve the symptoms with arthritis. Side effects are lower sperm count which may lead to male infertility.

o Immunosuppressants like Azathioprine, Cyclosporine, Cyclophosphamide are also given to control the symptoms. Side effects include increased risk of infection, high blood pressure, low blood counts.

o Interferon alfa 2b (Intron 2A) when used alone or with drugs is said to control skin sores, joint pain, eye inflammation. Side effects include flu -like symptoms.

o Infliximab (Remicade) works well against TNF — Tumor Necrosis Factor. Side effects include headache, skin rash and increased chances upper respiratory infection.

o In extreme cases, Plasmapheresis is used in cases of emergency.

§ Recent Findings –

o In a recent case study by Emmunqil H, Yasar Bilqe et al, it was concluded that intracardiac thrombus was a rare albeit serious complication of Behçet diease. Cases from four Neurology centers were studied that included Ankara University, Ege University, Hacettepe University and Eskişehir Osmangazi University Hospitals. Out of the candidates selected, 22 of them were diagnosed with intracardiac thrombus and the mean age presented out to be 29 years. Initial symptoms included chest pain, dyspnea, pulmonary arteritis, fever and haemoptysis. The medication given included Prednisone, Cyclophosphamide, Warfarin and Azathioprine.In more severe cases, it was combined with interferon 2b treatment.

It was thus concluded that Intracardiac Thrombus was severe complication that usually presented itself in males with predominance of occurring on the right side of the heart. However it was found to be treatable with early aggressive immunosuppressant and/or anti -coagulant therapy. Only one candidate died due to severe complications.

o According to a case report presented by Takayama K et al wherein a young pregnant woman of 30 presented with the symptoms of early manifestations of the disease at 12 weeks into pregnancy. After a treatment of Infliximab, the symptoms improved and she successfully gave birth to a 3.9 kg baby without any abnormality at 39 weeks. The symptoms reappeared and were thus controlled by a dosage of Infliximab. It was thus concluded that Infliximab may be safe and effective for Behçet’s Disease during pregancy.

§ Support Groups and Organizations Worldwide –

American Behçet Disease Association (ABDA): Presently situated in Rochester, Michigan, ABDA was founded in 1970 by Sheila Gregory, mother of a young Behçet’s patient in Orange County, California. Formerly it was known as American Behçet Disease Foundation. The motto of this foundation is ‘ Support — Educate — Advocate — Research.’ The organization can be reached at its volunteer staffed hotline 1–800–7BEHÇET (1–800–723–4238) wherein patients are trained to answer the calls.

UK Behçet’s Syndrome Society: Founded by Judith Buckle in 1983, the society aims at not only providing care and support to the patients suffering from Behçet’s disease but also provide financial aid, foster education, promote research and culminate interest in the medical organizations regarding this disease and collaborate with them.

Behçet’s International: It is an international organization that aims collaborating with all the international Behçet’s support group and forming a network thus ultimately assisting them achieve effective support.

§ Some of the other names by which Behçet disease is known:

o Adamantiades-Behçet disease

o Behçet syndrome

o Behçet triple symptom complex

o Behçet’s syndrome

o Old Silk Route disease

o Triple symptom complex

Works Cited

All Behçet’s Syndrome Patient Groups: RareConnect. 1 June 2017 <çet-s-syndrome/learn/patient-groups/see-all>.

Allnaimat, Fatima A. MedScape. 26 april 2016. 15 march 2017 <>.

American Behçet’s Disease Association. 17 April 2017 <http://www.Behç>.

American Behçet’s Disease Association. 1 June 2017 <http://www.Behç>.

Emmunqil, H, et al. PubMed. 28 July 2014 . 17 April 2017 <>.

Glick, Michael. Burket’s Oral Medicine. Shelton: People’s Medical Publishing House — USA, 2015.

Mayo Clinic. <çets-disease/symptoms-causes/dxc-20179084>.

Shiel Jr, William C. 17 April 2017 <çets_syndrome/article.htm>.

Takayama, K, et al. PubMed. 24 August 2013. 1 June 2017 <>.

Youth Ki Awaaz is an open platform where anybody can publish. This post does not necessarily represent the platform's views and opinions.

You must be to comment.

More from Sukant Khurana

Similar Posts

By Tanish Agarwal

By Jaidev Malik

By Fatem

    If you do not receive an email within the next 5 mins, please check your spam box or email us at

      If you do not receive an email within the next 5 mins, please check your spam box or email us at

        If you do not receive an email within the next 5 mins, please check your spam box or email us at

        Wondering what to write about?

        Here are some topics to get you started

        Share your details to download the report.

        We promise not to spam or send irrelevant information.

        Share your details to download the report.

        We promise not to spam or send irrelevant information.

        An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

        Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

        Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

        The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

        Read more about his campaign.

        Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

        Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

        Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

        Read more about her campaign.

        MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

        With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

        Read more about her campaign. 

        A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

        As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

        Find out more about the campaign here.

        A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

        She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

        Read more about the campaign here.

        A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

        The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

        Read more about the campaign here.

        A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

        As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

        Let’s Talk Period aims to change this by

        Find out more about her campaign here.

        Share your details to download the report.

        We promise not to spam or send irrelevant information.

        A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

        A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

        Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

        A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
        biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

        Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
        campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

        Sign up for the Youth Ki Awaaz Prime Ministerial Brief below