CHRONIC NON-HEALING LEG ULCER AS A MANIFESTATION OF UNDIAGNOSED BEHÇET’S DISEASE

Abstract

Chronic ulcerations constitute a considerable clinical challenge, frequently requiring individualized, multidisciplinary therapeutic strategies and rigorous adherence to treatment regimens. Precise diagnosis and effective management are predicated upon a comprehensive understanding of the ulcer's underlying etiology and associated systemic pathologies. This case report delineates the clinical course of a 35-year-old male patient presenting with a chronic, non-healing leg ulcer complicated by a history of deep vein thrombosis (DVT) and pulmonary thromboembolism. Although initial investigations for common vasculitic and prothrombotic profiles yielded negative results, histopathological analysis of a biopsy specimen revealed leukocytoclastic vasculitis. Subsequent genetic testing for HLA-B51 positivity confirmed the diagnosis of Behçet’s disease. The patient was managed with a therapeutic regimen comprising prednisolone, mycophenolate mofetil, and rivaroxaban, which resulted in significant clinical improvement and regression of the ulceration. This report underscores the clinical imperative to include Behçet’s disease in the differential diagnosis for young male patients who present with chronic non-healing ulcerations in conjunction with thromboembolic phenomena. Prompt diagnosis and vigilant, multidisciplinary management are crucial for mitigating severe complications, including pulmonary artery hemorrhage and neuro-Behçet’s disease. This case report accentuates the necessity for comprehensive diagnostic evaluations and sustained long-term surveillance to avert irreversible organ damage and enhance patient prognoses.