Be on the lookout for leukoaraiosis with mouth ulcers

  Leukoaraiosis is a chronic systemic disease that most often develops in young adulthood and is characterized by recurrent oral ulcers, genital ulcers, skin and eye lesions. The incidence of leukoaraiosis is low and there is little public awareness of it. In the north of the country, the prevalence of the disease is no less than 14/100,000. It is also known as Silk Road disease because of its prevalence with the Chinese, Iranian Iraqis and other countries.  Mouth ulcers are usually the first symptom of leukoaraiosis and are not very different from the usual recurrent mouth ulcers. The ulcers are multiple (usually 3 to 5), often involving the soft palate and oropharynx, and have severe pain. The ulcers start as “nodules” and quickly develop into rice- to soy-sized ulcers, round or irregular in shape, with clear but uneven margins and varying depths, with a light yellow covering at the base of the ulcer and a red halo around it. Meanwhile, 80% of patients with leukoaraiosis have combined genital ulcers (mainly in the scrotum and penis area in male patients and in the labia, vagina and cervix in female patients), which are generally deeper and larger than oral ulcers, less numerous, more painful and slower to heal.  In addition to ulcers, the disease can involve all systems of the body, such as the eye (anterior uveitis, posterior uveitis, retinitis, retinal vasculitis, which can involve all layers of the eye), joints (arthritis in 50% of patients), nervous system (neuropathy in 5% of patients), heart (valve damage, myocarditis, pericarditis), blood vessels (thrombophlebitis, venous thrombosis, inflammation of blood vessels at all levels, small and large, hemangioma). inflammation, hemangioma), gastrointestinal tract (dyspepsia, constipation, gastrointestinal ulcer, gastrointestinal perforation), kidney (glomerulonephritis, amyloidosis), skin (erythema nodosum-like, acne-like, papulopapular lesions), etc.