BEHCET ‘S DISEASE

Behçet’s Disease was first described by a Turkish doctor in 1937. A Skin and Venereal
Diseases Specialist Prof. Dr. Hulusi Behçet, recurrent sores in the mouth and genital area (medically
It has announced this disease to the whole world with its triple finding of ulcer or aphthae) and inflammation of the eye (uveitis).
In subsequent studies, Behçet’s disease is a disease that can affect many systems with various signs and symptoms.
disease has been demonstrated.

In which parts of the world does Behçet’s disease occur? What is the incidence in our country?

Although Behçet’s disease is seen almost all over the world, such as Turkey, Israel, Greece and Cyprus.
Mediterranean countries, Middle Eastern countries such as Iraq and Iran, and Far Eastern countries such as Japan, Korea, China
more common than in other countries. The above-mentioned and historical “Silk Road” of the disease passed through
It is more common in these countries, genetic and/or environmental factors may be effective in its development.
is pointing. The most common place for Behçet’s disease among the countries on the historical “Silk Road”
It is Turkey. In five different studies conducted in various regions of our country, the frequency of the disease was found to be 100,000.
It has been reported to be between 20 and 421 in adults.

Behçet’s disease is more common in which gender?

Behçet’s disease occurs at approximately equal rates in men and women. However, especially the eye and vascular
Significant system involvements such as involvement occur more frequently in young male patients.

At what age does Behçet’s disease occur?

Behçet’s disease most commonly begins between the ages of 20 and 40. However, less frequently
Behçet’s disease can also develop in children and elderly people.

What are the causes of Behçet’s disease?

The cause of the disease is not fully known. In addition to the immune system changes in the development
genetic and some environmental factors (such as bacteria and viruses) are thought to be effective.

Is Behçet’s disease contagious?

It is not a contagious disease.

Is Behçet’s disease hereditary?

Behçet’s disease is not an inherited disease. However, there is a genetic predisposition for the disease.
This means that the incidence of Behçet’s disease in individuals with close blood ties is higher than that of other individuals in the community.
slightly higher than that of individuals. The tissue called HLA-B51 in a significant part of the patients
antigen can be detected. However, HLA B51 is a common tissue antigen in our population and

It should not be forgotten that it can also be seen in healthy individuals from all aspects. Therefore, Behçet alone
It is not suitable for use in the diagnosis of the disease.

What are the symptoms of Behçet’s disease?

Behçet’s disease is a disease that can affect many organs and therefore cause many symptoms.
is a disease. The most common symptoms are recurrent sores in the mouth and genitals, skin symptoms, eye and
joint involvement.
Mouth sores (aphtha or oral ulcer); Painful and recurrent mouth sores are the most common cause of Behçet’s disease.
seen symptom. Mouth sores, which are extremely important in the diagnosis of the disease, occur in almost all patients.
is observed. They are usually located on the lip and cheek mucosa, the lateral and lower surfaces of the tongue and the floor of the mouth.
Mouth sores, round or oval, with swollen edges and surrounded by a red halo, with a white, gray or gray base at the base
they are yellow in color. Pain is the most important complaint. Occasional feeding difficulties and speech
they can cause strain. Surface wounds less than 1 cm in size, within 15 days, without a trace
While healing, wounds larger than 1 cm and deep may heal in a longer time and leave scars. Mouth
The frequency of recurrence of wounds varies from patient to patient. Behçet’s is the only disease that causes aphtha in the mouth.
It’s not a disease. Recurrent mouth sores called recurrent aphthous stomatitis occur in approximately 20% of the population.
can be seen. This condition is characterized by mouth sores only, regardless of an underlying disease.
It is a common condition in healthy individuals. Therefore, how frequent or
No matter how severe it is, it is not enough to make a diagnosis of Behçet’s disease. Behçet’s disease diagnosis
In order to be diagnosed, that person must have other clinical signs of the disease in addition to aphthae.
genital sores (genital ulcer); Dr. One of the three unique symptoms defined by Hulusi Behçet
Recurrent genital sores are one of the most important symptoms characterizing the disease. genitalia
sores are the second most common symptom of the disease after mouth sores. In about 80-90% of patients
they are found. Its appearance and course are similar to mouth sores. However, they are usually deeper and often scar.
they get better. They recur less frequently than mouth sores. Sexual area wounds, in addition to pain
causes difficulties in physical movements. Bags are the most common location in men.
In women, the most common location is the lips. However, ulcers can reach the uterus and even the cervix.
can settle. It can manifest itself with discharge and pain during sexual intercourse. genital area wounds
It is not contagious like other findings.
Skin findings; The skin manifestations of the disease show a great variety. These include erythema nodosum,
papulopustular lesions and superficial thrombophlebitis are the most common. Patients with erythema nodosum
It is a skin symptom seen in approximately 1/3 of the cases and frequently detected in female patients. Most common in the front of the legs
shows placement on the face. Less commonly on the hips, arms, or other parts of the body.
it could be. They are round or oval, painful, red in color, their size varies between hazelnut and walnut.
Erythema nodosum does not open and become a wound. Symptoms are usually a transient dark color in place in 2-3 weeks.
It heals by leaving a stain. Papulopustular lesions of the skin resembling hair follicles or pubertal acne
are symptoms. These symptoms, similar to red, inflamed acne, are often located on the trunk, legs, arms and face.
they show. Superficial thrombophlebitis is another important skin manifestation. Often affected on the legs and skin
It is manifested by red, tender, streak or strip-like hardness along the vein. In male patients
occurs more frequently.
eye involvement; Ocular involvement in Behçet’s disease is seen in approximately half of the patients. eye redness,
It causes complaints such as blurred vision or vision loss, floaters, pain in and around the eyes.
Eye complaints are more common in males and in the first years of the disease. Severe eye involvement in some patients
It should be kept in mind that it can watch and even lead to vision loss. Therefore above
In case of the summarized complaints, it is necessary to consult a doctor without wasting time and seek treatment.
Regular use of the prescribed drugs is of great importance. Eye involvement sometimes leads to a very obvious complaint.
may not turn on or be unnoticed by the patient. Therefore, whether patients have eye complaints or not.
It is useful to have it examined at regular intervals.
Joint involvement; About half of the patients have joint complaints. Complaints are just pain
may be in the form of swelling, temperature increase and limitation of movement (medical name arthritis) in the joint in question.
can be in the form. Complaints may be limited to just one attachment. Sometimes several joints at the same time
amount. The knee joint is most commonly involved, followed by the ankle, elbow, and wrist, in order of frequency. Behcet
Spinal joints may also be involved less frequently in the disease. Joint complaints attack of the disease
It is more evident in the periods of time and often there is no permanent damage or damage to the joint within 2-4 weeks.
heals without injury.

Other symptoms of Behçet’s disease; Veins in Behçet’s patients other than those mentioned above
(bloody sputum as a result of inflammation in the pulmonary artery, clotted inflammation in the veins, namely thrombophlebitis
as a result of painful strip-like rashes, swelling in the feet, etc.), intestines (abdominal pain, nausea, vomiting, diarrhea,
bloody diarrhea, etc.) and nervous system-related complaints (headache, sensory defects, double vision, imbalance,
speech and swallowing difficulties, unconsciousness, etc.) may occur. with such complaints
It is beneficial for patients to consult a doctor without wasting time.

What is the course of Behçet’s disease?

Behçet’s disease follows a long-term course with unpredictable attacks and periods of remission.
The symptoms and severity of the disease can vary from person to person. In some, only skin, mucous membranes and mild
While joint complaints are observed, in some, eye, vascular, gastrointestinal and nervous system symptoms are in the foreground.
it could be. In general, the severity of the disease decreases with advancing age.

Does pregnancy affect the course of the disease?

Behçet’s disease can become pregnant. Behçet’s disease on pregnancy or Behçet’s disease of pregnancy
does not have a very significant effect on In some patients, while the complaints decrease during pregnancy, it increases in others.
However, most patients do not have a significant change.

How is Behçet’s disease diagnosed?

There is no laboratory marker for the definitive diagnosis of the disease. Whether the person has Behçet’s disease
There is no blood test to show that it is not or will develop in the future. diagnosis for today
established by clinical findings. Skin and mucosal findings are often the first signs of the disease.
they come out. Therefore, they are of great importance in the early diagnosis of the disease.

What is a pathergy test? What does it do? How is it looked after?

The skin pathergy test is the skin’s response to the insertion of the appropriate needle tip into the skin. In the diagnosis of the disease
used as an auxiliary test. It is applied superficially on the inner surface of the forearm. At a 45 degree angle to the skin
needle tip is inserted. In those with positive pathergy test, redness in this area that may be inflamed after 24-48 hours
acne-like formation occurs. Often the same needle tip has multiple skins on both arms.
immersed in the field. Although the skin pathergy test is specific to the disease, it may not be detected in every patient. In our country
The positivity of the test in Behçet’s patients is about 60-70%. Skin pathergy test positivity alone
It is not sufficient for the diagnosis of Behçet’s disease. Similarly, if the test is negative, that person’s Behçet
It doesn’t mean he isn’t sick.

How is Behçet’s disease treated?

Long-term and regular follow-up of the disease is required. Systemic Behçet’s disease
It should not be forgotten that it is a disease and can affect many organs. Therefore, the disease
Collaboration of many disciplines (doctors from different specialties) in the approach
required. Skin and venereal diseases, rheumatology and eye diseases in the treatment and follow-up of patients
It is of great importance that many doctors, especially specialists, work in harmony.
In general, there is only one drug or treatment that completely eliminates all the symptoms of Behçet’s disease.
not available. Therefore, the treatment is determined according to the characteristics of the existing symptoms. Basic in treatment

The aim is to damage the organ or organs that may be severe, especially in the early and active phase of the disease.
to prevent and relieve the discomfort caused by the symptoms. Many drugs in the treatment of the disease
is used. Some of them are applied locally and some are applied systemically. Also necessary
In some cases, physical therapy and surgical treatments can be performed. Local drugs (mouthwash, cream, etc.)
in the sense of alleviating the symptoms of the mucosa, healing faster and eliminating the discomfort it causes.
are important drugs. Colchicine is a drug that can be useful in skin, mucous membrane and joint involvement. Except this
when necessary, cortisone drugs, drugs that suppress the immune system, controlled
can be used. Oral health can be important in preventing aphthae and new attacks of the disease. This
Therefore, patients should attach great importance to oral hygiene and have regular dental examinations.
is necessary. Tooth decay, gingivitis, etc. All the negativities that can cause oral hygiene disorder
must be treated. In addition, patients with oral aphthae are acidic, crusty, hard, bitter or salty.
Irritating agents such as food and alcoholic beverages should be avoided. Especially shelled foods
Ingestion (cookies, hazelnuts, peanuts, sunflowers, etc.) may cause irritation and minor injuries in the mouth.
It can initiate the formation of aphthae and prolong the recovery period. The above and attention
Apart from many issues that need to be addressed, conditions such as extreme fatigue, stress, and fever
Although they do not cause disease, they may play a role in increasing the disease in some people. Behcet as much as possible.
Patients should avoid fatigue and stress and protect themselves from infections. drug selection and
The determinant in the duration of the treatment is the organ or organs involved and the severity of the involvement. Sometimes
Multiple drugs may need to be used together to relieve symptoms. The type of treatment to be chosen and
The route of administration, duration of treatment, dose of drugs are regulated by the physician. Treatment of the disease and
In the follow-up of the patient, the patient’s recommended
Compliance with treatment is just as important.

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