Anti-tumour necrosis factor alpha (TNFα) was used in seven patients (15.2 %); adalimumab in five patients, infliximab in one patient and etanercept in one patient, at 19 (3.3–109) months after disease onset; 6/7 had severe gastrointestinal symptoms and one patient had relapsing genital ulcers refractory to other systemic medications. The gene discussed is TNF; the disease is Genital ulcers.