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Pathergy test (PT) is used for the diagnosis of Behcet’s disease (BD). It is a criterion in many classification/diagnosis criteria. PT is mainly seen in BD but can be seen in other conditions too. PT has been reported with high frequency from most countries along the Silk Road. The sensitivity of pathergy phenomenon (PP) is declining over the time. The aim of this study was to look for the diagnostic value of PT in the past and at the present time. The BD registry (Rheumatology Research Center, Tehran University of Medical Sciences) has the data of 6,607 BD and 4,292 control patients. Patients and controls were divided in four groups of 1,650 BD and 1,073 controls. Sensitivity, specificity, positive and negative predictive value (PPV-NPV), positive and negative likelihood ratio (PLR-NLR), diagnostic odds ratio (DOR), and Youden’s index (YI) were calculated for each group. The first and the fourth quartiles were …