Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about Beshet's disease. And you can find written notes on this topic at

zero to finals.com slash Beshitz or in the rheumatology section of the second edition of the zero to finals medicine book.

So let's get straight into it.

Beshet's disease is a complex inflammatory condition affecting the blood vessels and the tissues.

The main features are recurrent oral and genital ulcers.

It can affect other areas such as the eyes, skin, gastrointestinal tract, lungs, blood vessels,

muscular skeletal skeletal system and central nervous system.

Symptoms can range from mild to severe.

There's a link with the HLA B-51 gene. Let's start with the differential diagnosis of the most commonly presenting feature, which is mouth ulcers. Mouth ulcers are very common

and have a long list of possible causes. Simple aptus ulcers are very common and have a long list of possible causes.

Simple aptus ulcers are very common without any associated disease.

Other differentials are squamous cell carcinoma, herpesymplex virus,

hand-foot and mouth disease caused by Coxsacky A virus,

inflammatory bowel disease, for example Crohn's disease,

celiac disease, connective tissue diseases, for example rheumatoid arthritis and systemic lupus erythematosis,

vitamin deficiency, for example deficiency in iron, B12, folate or vitamin D, and HIV.

Let's talk in more detail about the features of Beshett's disease.

Oral ulcers are expected at least three times per year in patients with the disease.

They are painful,

sharply circumscribed erosions with a red halo on the oral mucosa inside the mouth. They heal over two to four weeks. Genital ulcers are similar in appearance to the oral ulcers. The ulcers may leave a scar.

Beshit's disease can affect many organs in the body, including the skin with erythema nodosum

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