From the Guidelines
Behcet's disease is a chronic inflammatory disorder characterized by a relapsing and remitting course, requiring prompt suppression of inflammatory exacerbations and recurrences to prevent irreversible organ damage. The goal of treatment is to individualize care according to age, gender, type, and severity of organ involvement, as well as patient preferences 1. Key characteristics of the disease include:
- Recurrent oral and genital ulcers
- Eye inflammation
- Skin lesions
- Potential for vascular, neurological, and gastrointestinal involvement, which may be associated with a poor prognosis 1
- A tendency for disease manifestations to ameliorate over time in many patients 1
Treatment strategies vary based on the severity and type of organ involvement:
- For mild oral and genital ulcers, treatment can be tailored according to the patient's need and quality of life impact, with options including topical corticosteroids and colchicine 1
- For more severe disease, particularly with ocular, vascular, or neurological involvement, aggressive treatment with immunosuppressants and corticosteroids is often necessary to prevent serious damage and vision loss 1
- A multidisciplinary approach involving rheumatology, ophthalmology, and dermatology is essential for optimal care 1
It is crucial to note that the disease's relapsing and remitting nature, as well as differences in natural course between men and women, mandate individualized treatment approaches 1. Regular monitoring for disease activity and medication side effects is also vital to ensure the best possible outcomes.
From the Research
Definition and Characteristics of Behcet's Disease
- Behcet's disease (BD) is a chronic, relapsing inflammatory, multisystem disease of unknown etiology 2, 3, 4, 5, 6
- The disease has a wide clinical spectrum of mucocutaneous lesions and ocular, vascular, articular, neurologic, gastrointestinal, and cardiac involvement 2
- It is characterized by a course of exacerbations and remissions which gradually abate with time 6
Clinical Manifestations
- Mucocutaneous lesions, such as oral and genital ulcers, are common manifestations of the disease 2, 4, 6
- Ocular involvement, including uveitis, can lead to severe vision impairment despite immunosuppressive therapy 3, 4, 6
- Vascular, articular, neurologic, gastrointestinal, and cardiac involvement can also occur, leading to increased morbidity and mortality 2, 5, 6
Treatment Approaches
- The primary goal of treatment is the prevention of irreversible organ damage 2
- Treatment varies depending on the organ involved and the severity of the involvement, and should be personalized and arranged with a multidisciplinary approach 2
- Immunosuppressive and immunomodulatory drugs, such as azathioprine, cyclosporine, and corticosteroids, are commonly used to induce and maintain remissions 2, 4, 5, 6
- Biologic agents, such as tumor necrosis factor alpha inhibitors, may be used for refractory cases 3, 5