Late onset Behçet's disease

Behçet's disease is characterized by recurrent mouth ulcerations associated with two of the following clinical manifestations: recurrent genital ulcerations, ophthalmic and cutaneous lesions and a positive Pathergy test. The young adult is the most affected, usually in the third and fourth decades, with an exceptional onset after the age of 60 years. We report two cass of late onset Behçet's disease, occurring after the age of 70 years. The first case is a 70-year-old Lebanese male complaining of asymmetrical oligoarthritis, uveitis, oral ulcerations, ear chondritis, pseudofolliculitis and pustular rash, all corticosensitive. The second is the case of a 72-year-old Lebanese female who presented with posterior uveitis and retinal vasculitis, bipolar cutaneous ulcerations and a positive family history of Behçet's disease; all the symptoms were stabilized by immunosuppressive therapy. We discuss the differential diagnoses and the particularities of this late onset and emphasize the necessity of establishing an early diagnosis of Behçet's disease, even at an older age, and the need to start an adequate treatment in order to prevent serious ophtalmic and systemic complications.