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               Telah dilaporkan satu kasus ulkus vulva rekuren tersangka penyakit Behçet pada seorang wanita berumur 25 tahun, belum menikah datang ke Rumah Sakit Cipto Mangunkusumo (RSCM) dengan luka besar pada kemaluan sejak 8 bulan, disertai dengan demam subfebris, dan benjolan sebesar telur puyuh pada lipat paha kiri. Pasien juga mempunyai riwayat sariawan di mulut lebih dari 3 X/tahun selama 5-6 tahun dan pernah mengalami dua kali luka di kemaluan. Riwayat kontak seksual 5 tahun yang lalu. Tidak terdapat tanda-tanda fotofobia, nyeri di sekitar mata, konjungtivitis, kelainan mata lain, dan lesi kulit. Pemeriksaan laboratorium terhadap human immunodeficiency virus (HIV) non-reaktif, Ig M and Ig G terhadap herpes simplex virus (HSV) tipe 2 sedikit meningkat dan tes serologi untuk sifilis negatif.  Tes patergi memberikan hasil negatif. Terapi yang diberikan terdiri atas seftriakson, gatifloksasin, asiklovir, co-amoxiclav®, dan kompres betadine 1/10, tetapi tidak memberikan hasil. Terapi yang dengan metilprednisolon dan kolkisin selanjutnya memberikan hasil memuaskan.

                Penyembuhan ulkus mendukung diagnosis ke arah penyakit Behçet. Kriteria penyakit Behçet pada kasus ini belum terpenuhi karena tidak ditemukan lesi mata, lesi kulit, dan tes patergi yang positif. Beberapa penelitian menunjukkan bahwa lesi mata pada penyakit Behçet dapat terjadi 2-4 tahun setelah awitan penyakit, sedangkan lesi kulit dan tes patergi yang positif tidak selalu ditemukan. (MDVI 2007;34/2: 75-79)

Kata kunci :  ulkus oral rekuren, ulkus vulva rekuren, penyakit Behçet

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               A case of wide recurrent vulvar ulcer suspected Behçet's disease in a 25-year-old unmarried woman came to Cipto Mangunkusumo Hospital  with a large painful ulcer on the lower half of her external genitalia for the last 8 months, subfebril fever, and lump as big as quail egg on her left groin. She also had history of recurrent oral ulcer more than 3 times since 5-6 years and on had experienced twice vulvar ulcer. She had a sexual contact 5 years ago. There were no sign of photohobia, periorbital pain, conjunctivitis, any other eye defects, and skin lesions. Laboratory findings revealed non reactive human immunodeficiency virus (HIV), slightly elevated immunoglobulin (Ig) M and Ig G of herpes simplex virus (HSV) type 2, and negative  serologic tests for syphilis. Pathergy test was negative. Therapy given consisted of ceftriaxon, gatifloxacin, acyclovir, co-amoxiclave®, and betadine wet dressing 1/10, but the result was unsatisfactory. Further additional treatment with methylpredisolon and colchicines gave an excellent result.

Complete healing of the ulcers supported Behçet's disease. The criteria of Behçet’s disease was not fulfilled yet in the absence of eye lesions, skin lesions, and positive pathergy test, but many studies revealed that eye lesions on Behçet's disease occur 2-4 years after the outset of the disease, skin lesions and positive pathergy test are not reliable enough. (MDVI 2007; 34/2: 75-79)

Keywords : Recurrent oral ulcer-recurrent vulvar ulcer-Behçet’s disease