Is acne vulgaris seen more often in Behcet Disease than in the normal population?

Abstract: Background: In the literature, some of the skin pustular lesions of BD resembling the pustular lesion of acne vulgaris (AV) was called acneiform lesion of BD. It was suggested that AV was seen more often in BD than in normal population. AV is a common and very frequent skin lesion. The lesions are polymorphic, and are non­inflamed (closed or open comedones) or inflamed (papules, pustules, nodules). Objectives: To find if AV is seen more frequently in BD than in normal population and to find if there is a relation between the two entities. Material and methods: We screened systematically 84 consecutive BD patients and 117 subjects among the hospital staff. We examined every subject on the face and trunk, especially on the back, for comedones (closed or open), papules and pustules. Ten lesions or more were considered as positive if they were formed by comedones alone, or comedones plus pustules and papules together. The statistical calculation was done by the chi square test. A confidence interval (CI) at 95% was calculated for the means and the percentages. Results: In BD group, 48 were males and 36 were females (sex ratio 1.33/1). The mean age was 34 years. In control subjects, 68 were males and 49 were females (sex ration 1.39/1). The mean age was 31.2 years. In BD group, 30 patients had AV (35.7%, CI: 10.3). In the control group, 47 had acne (40,2% CI: 8.9). The difference was not statistically significant (X2: 0.411, p: 0.52). Pustular lesions (pseudo folliculitis) were seen in 39 BD patients. Among them 16 had AV. Pustular lesions were absent in 45 patients. Among them 21 had AV. The comparison was not statistically significant (X 2: 0.547, p: 0.46). Discussion: AV was seen with the same frequency in BD and in controls. The pathogenesis of pustular lesions of BD is different from those of AV. The first one is a vasculitis while the second is a sebaceous gland disorder under hormonal factors. The pustular lesion of BD is located more often on the lower part of the body, while the pustules of AV are seen more frequently on the upper part of the body. Our study showed that AV was not more frequent in BD patients with pustular lesions than in those without it. We may conclude that the so-called acneiform lesions of BD, reported in the literature, was whether an AV that may be seen in BD patients, or a special clinical form of BD pustular lesion resembling AV pustules. Conclusion: There is no relation between AV and BD, but they can coexist together.