However, the FP realized that
pathergy could be stimulated by a biopsy, so he decided to refer the patient to Dermatology.
In 2010, in an effort to improve clinical sensitivity in diagnosing BD, revised diagnostic criteria were proposed by the international criteria for BD.[2] These criteria included oral aphthosis, genital ulcers, ocular manifestations, skin lesions, vascular manifestations of different sizes in various organs, central nervous system involvement, and positive
pathergy test.
A
pathergy test was performed on the flexor forearm by inserting a 20-gauge intradermal sterile needle obliquely and then injecting 0.1 ml of normal saline solution.
Pathergy test, ophthalmologic examination, whole blood count, routine biochemical tests, serum iron, folic acid, ferritin and vitamin B12 levels were examined.
At the same time, positive
pathergy test appeared on the site of bone marrow puncture.
"Because of the simplicity and the lack of trauma, you don't get the
pathergy you normally see on someone with pyoderma gangrenosum."
At his initial presentation, our patient did not meet International Study Group criteria for the diagnosis of Behcet's disease because he lacked skin and ocular lesions and genital/oral ulcers and had a negative
pathergy test [12].
All patients were subjected to a
pathergy test by immersing a 12-gauge injector needle into the forearm skin.
Pathergy is an important feature that, if present, can support the diagnosis of PG.
(vii)
Pathergy test as an extra criterion to be used if conducted and positive
The ICBD criteria included recurrent oral and genital aphthosis, eye lesions (anterior or posterior uveitis, cells in vitreous on slit lamp examination, and retinal vasculitis), skin lesions (erythema nodosum, pseudofollicolitis or papulopustular lesions, and acneiform nodules), neurological manifestation, vascular manifestation, and/or a positive
pathergy test [62].
These criteria require the presence of oral ulcers, in addition to two or more of the following manifestations: genital ulceration, eye lesions (uveitis, retinitis), skin lesions (folliculitis, papulopustular lesions, acneiform nodules, erythema nodosum), and a positive
pathergy test (1).