Elajami Marwa H
Gynecology, CosmeSurge Group, Dubai, ARE.
Cureus. 2024 Nov 26;16(11):e74476. doi: 10.7759/cureus.74476. eCollection 2024 Nov.
Behçet's disease (BD) is a systemic auto-inflammatory vasculitis. The clinical pictures of BD involve the skin and mucosal membranes such as oral and genital ulcers, ocular lesions, cardiovascular, gastrointestinal, muscular, nervous systems, and joints. A 38-year-old woman was repeatedly suffering from oral, genital, and ocular lesions, wound dehiscence after any surgical procedure, and joint pain. She has a family history where multiple relatives were affected by BD. The patient had an abdominoplasty two years ago with delayed wound healing and keloid formation. The patient presented with an asymmetrical labia majora with multiple lumps after fat transfer, multiple vaginal cysts, and a chronic Bartholin's cyst for three years. She consulted surgeons to correct the deformity and for cyst excision, but there was a great risk of keloid formation, dehiscence, and infections. This was a challenge for her surgery. The patient was on colchicine and corticosteroids. BD affects multiple systems, most commonly the healing of the skin and the mucous membranes. This causes difficulties in deciding to undergo surgery because of the risks. The diversity of the manifestations of BD requires a spectrum of pre-surgical adjustments in inflammatory markers, medication doses, and improving general patient conditions. Furthermore, the intra-operative and post-operative use of the recent regenerative medicine methods might provide the best surgical healing outcomes in these groups of patients. This is most challenging with BD but can be achieved regardless.
白塞病(BD)是一种全身性自身炎症性血管炎。BD的临床表现累及皮肤和黏膜,如口腔溃疡、生殖器溃疡、眼部病变、心血管系统、胃肠道、肌肉、神经系统和关节。一名38岁女性反复出现口腔、生殖器和眼部病变,任何手术后伤口裂开,以及关节疼痛。她有家族病史,多名亲属患有BD。该患者两年前接受了腹部整形手术,伤口愈合延迟并形成瘢痕疙瘩。患者脂肪移植后出现不对称大阴唇伴多个肿块、多个阴道囊肿,以及慢性巴氏腺囊肿三年。她咨询外科医生以纠正畸形并切除囊肿,但存在瘢痕疙瘩形成、裂开和感染的巨大风险。这对她的手术来说是一项挑战。该患者正在服用秋水仙碱和皮质类固醇。BD影响多个系统,最常见的是皮肤和黏膜的愈合。由于存在风险,这给决定是否进行手术带来困难。BD表现的多样性需要在炎症标志物、药物剂量以及改善患者总体状况方面进行一系列术前调整。此外,在这些患者群体中,术中及术后使用最新的再生医学方法可能会提供最佳的手术愈合效果。这对白塞病来说极具挑战性,但无论如何都可以实现。