Differential Diagnosis for Mouth Ulcers, Erythema Nodosum, Weight Loss, and Uveitis
The combination of mouth ulcers, erythema nodosum, weight loss, and uveitis suggests a systemic condition with autoimmune, inflammatory, or infectious etiologies. Here's a categorized differential diagnosis:
Single Most Likely Diagnosis
- Behçet's Disease: This condition is characterized by recurrent mouth ulcers, genital ulcers, uveitis, and skin lesions, including erythema nodosum. The presence of these symptoms aligns closely with the diagnostic criteria for Behçet's Disease, making it a strong candidate for the single most likely diagnosis.
Other Likely Diagnoses
- Sarcoidosis: This systemic granulomatous disease can cause uveitis, erythema nodosum, and weight loss. While mouth ulcers are less common, they can occur, especially in the context of gastrointestinal involvement.
- Inflammatory Bowel Disease (IBD): Both Crohn's disease and ulcerative colitis can present with oral ulcers, weight loss, and extraintestinal manifestations like erythema nodosum and uveitis.
- Systemic Lupus Erythematosus (SLE): SLE is a multisystem autoimmune disease that can cause a wide range of symptoms, including oral ulcers, erythema nodosum, weight loss, and uveitis.
Do Not Miss Diagnoses
- Tuberculosis: Although less common, tuberculosis (TB) can cause a variety of systemic symptoms, including weight loss, uveitis, and erythema nodosum. Oral ulcers can also occur, especially in the context of pulmonary TB. Missing TB could be fatal if not treated promptly.
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can present with systemic symptoms like weight loss and can cause uveitis and erythema nodosum. Oral ulcers are less common but can occur, particularly in the setting of immunosuppression.
Rare Diagnoses
- Relapsing Polychondritis: This rare autoimmune disorder affects cartilage and can cause a variety of symptoms, including eye inflammation (uveitis), skin lesions, and potentially oral ulcers. Weight loss can occur due to systemic inflammation.
- Sweet Syndrome (Acute Febrile Neutrophilic Dermatosis): Characterized by fever, neutrophilia, and tender erythematous skin lesions, Sweet Syndrome can also cause oral ulcers and uveitis. It is a rare condition but should be considered in the differential diagnosis due to its potential for systemic involvement.
- Granulomatosis with Polyangiitis (GPA): Formerly known as Wegener's granulomatosis, GPA is a rare autoimmune disorder that affects small- and medium-sized vessels. It can cause a wide range of symptoms, including oral ulcers, weight loss, uveitis, and skin lesions like erythema nodosum.