What is the diagnosis for a patient with recurrent oral and genital ulcers, no skin lesions, previously treated with prednisolone and colchicine, now presenting with a specific rash on the face and back, and multiple acneiform-like lesions on the back, indicated for HLA-B51 testing for Behcet's disease?

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Differential Diagnosis for Recurrent Oral Genital Ulcers

  • Single most likely diagnosis
    • Behcet's Disease: This condition is characterized by recurrent oral and genital ulcers, and the presence of acneiform lesions on the back, along with a specific rash, supports this diagnosis. The indication for HLA B51 testing further points towards Behcet's Disease, as this genetic marker is commonly associated with the condition.
  • Other Likely diagnoses
    • Reiter's Syndrome: Although less likely given the absence of skin lesions initially and the specific pattern of symptoms, Reiter's Syndrome can present with oral and genital ulcers, along with skin manifestations.
    • Stevens-Johnson Syndrome: This condition can cause oral and genital ulcers, but it typically includes skin lesions and is often associated with medication use or infections.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Lupus: Systemic Lupus Erythematosus can cause a wide range of symptoms, including oral and genital ulcers, and skin rashes. Missing this diagnosis could lead to significant morbidity and mortality due to its potential to affect multiple organ systems.
    • Infectious Causes (e.g., Syphilis, HIV): Certain infections can cause oral and genital ulcers, and missing these diagnoses could lead to severe consequences, including transmission to others and progression of disease.
  • Rare diagnoses
    • Sweet Syndrome: A rare condition characterized by fever, leukocytosis, and tender, erythematous, well-demarcated papules and plaques, which can sometimes include oral and genital ulcers.
    • PFAPA Syndrome (Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis): Although more common in children, this syndrome can cause recurrent oral ulcers and might be considered in the differential diagnosis of recurrent oral and genital ulcers, especially if other symptoms like fever and adenitis are present.

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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