Complication of acupuncture in a patient with Behçet's disease

We would like to bring to your attention a complication resulting from acupuncture in a patient with Behçet's disease.

Case report

A 35 year old white man, who fulfilled the International Study Group criteria¹ for Behçet's disease, attended the Behçet's clinic at the Birmingham and Midland Eye Centre. He complained of four red areas on his left arm (Fig 1). Two days earlier he had undergone acupuncture for what he described as “tennis elbow.” These red areas corresponded to where the acupuncture needles had been inserted. Examination revealed these areas to be pustules (inset) that were characteristic of a positive pathergy test.

Figure 1.

Arrows indicating pustules corresponding to a positive pathergy test. Inset: magnified image of one pustule.

Comment

A positive pathergy test is an important diagnostic sign of Behçet's disease.¹ Its prevalence varies by geographic region, being less common in patients from Northern Europe. Nevertheless, patients with Behçet's disease should be made aware of this potential complication if they intend to undergo acupuncture.