Is erythema (redness) of the feet at night a symptom of Behcet's disease?

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Reddish Pink Feet at Night and Behçet's Disease

No, reddish pink discoloration of the feet at night is not a recognized symptom of Behçet's disease. The characteristic skin manifestations of Behçet's disease are distinctly different and do not include this presentation.

Recognized Skin Manifestations of Behçet's Disease

The established cutaneous features of Behçet's disease include 1, 2:

  • Erythema nodosum-like lesions - These are the most diagnostically significant skin findings and carry greater diagnostic weight than other cutaneous manifestations 2
  • Papulopustular or acne-like lesions - These are treated similarly to acne vulgaris but have less diagnostic significance 1, 2
  • Genital ulcers - Present in 64-87% of patients and can cause scarring requiring aggressive treatment 3, 4
  • Oral aphthous ulcers - The hallmark feature, required for diagnosis 2, 5

What Reddish Pink Feet Might Actually Indicate

The symptom you describe—reddish pink discoloration of feet at night—is more consistent with:

  • Vascular insufficiency or dependent rubor - Common in venous stasis or peripheral arterial disease
  • Inflammatory conditions of the feet - Such as inflamed calluses or corns, which can appear red 1
  • Erythromelalgia - A condition causing redness and warmth in extremities, though not specific to Behçet's

Important Caveat About Vascular Involvement

While Behçet's disease does cause vascular involvement in approximately one-third of patients affecting both arteries and veins 6, 2, this typically manifests as:

  • Venous thrombosis (particularly deep vein thrombosis)
  • Arterial aneurysms (especially pulmonary)
  • Post-thrombotic syndrome with leg ulcers 6, 7

These vascular complications would present with more severe symptoms than simple reddish discoloration, including pain, swelling, ulceration, or thrombotic events 6.

Diagnostic Approach

If you suspect Behçet's disease, look for the actual diagnostic criteria 2:

  • Recurrent oral aphthous ulcers (mandatory finding)
  • Plus at least two of:
    • Recurrent genital ulceration
    • Uveitis or retinal vasculitis
    • Erythema nodosum-like lesions
    • Positive pathergy test

The isolated finding of reddish pink feet at night does not fit the established clinical picture of Behçet's disease and should prompt evaluation for other causes of lower extremity erythema.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Diagnostic Approach for Behçet's Disease

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Behcet's disease.

Clinical and experimental medicine, 2004

Guideline

Behçet's Disease Characteristics and Treatment

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Natural Course of Behçet's Disease Symptoms Over Time

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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