Atypical Behçet disease with endocarditis, pyoderma gangrenosum–like ulcers and methicillin-resistant Staphylococcus aureus–positive skin abscesses

Behçet disease (BD) is a neutrophilic dermatosis characterized by relapsing flares of orogenital aphthous ulcers, uveitis, and skin inflammation.1-3 Extracutaneous manifestations involve gastrointestinal, neurologic, pulmonary, and cardiac systems.1 The spectrum of skin manifestations includes erythema nodosum, papulopustular lesions, and pathergy. Skin abscesses, leukocytoclastic vasculitis, bullae, or lesions mimicking Sweet syndrome or pyoderma gangrenosum (PG) are rare.1-3 We describe a patient with atypical BD with endocarditis, PG-like ulcerations, and methicillin-resistant Staphylococcus aureus (MRSA)-positive abscesses, highlighting a unique constellation of infection and immune dysregulation.