Infliximab for the treatment of resistant oral ulcers in Behcet's disease: a case report and review of the literature

Recurrent oral and genital ulceration of Behcet's disease can be very distressing. Usually they are responsive to treatment with topical steroids, local anesthetics, oral colchicine and in severe cases steroids and even immuno-suppressive medications such as azathioprine, methotrexate and thalidomide. We describe a case of Behcet's syndrome in a 48-year old woman whose oral ulcers were resistant to a wide range of topical and systemic treatments and remained unchanged for 7 weeks. Administration of a single dose of infliximab resulted in complete remission and recovery of the mouth aphtae within 7 days. We also review the current English medical literature and summarize 5 more cases where anti-TNF agents were used in the treatment of recalcitrant orogenital ulceration in Behcet's disease.