What is Behcet’s Disease?

It is a rheumatic disease that was first described by Turkish dermatology professor Hulusi Behçet and named after him. It is common in Turks. Although painful ulcerated wounds in the mouth and genital area and inflammation called uveitis in the eye have basic and diagnostic symptoms, Behçet’s Disease is a vascular vasculitis that affects all organs and systems far beyond these symptoms. The most important reason why his clinic is so colorful is that it involves all veins, large and small, arteries and veins. While it progresses with slightly milder clinical findings in women, inflammation and related clinical manifestations are severe in men. The severity of the clinic varies in each patient. In some, it progresses with wounds only in the mouth and genital area for years, and in others, it can be seen with lung, digestive system and brain involvement. It can always be inflamed, and in some patients, it can be seen in the form of an attack and remission (well-being) cycle.

Reason?

Although it is known that it is more common in those with active HLA B5/B51 genetic locus, pathogenesis studies are continuing today. It is known that the inflammation in the vessels is caused by the deterioration of the tolerance of the vessels in the immune system and the initiation of the inflammation by the defense system. Environmental/epigenetic factors, hormones can pull the trigger. It is not a contagious disease and there is no absolute transmission between generations. It is common in countries on the historical Silk Road (Turkey, Iran, Asian countries and Japan). 20-30 years of age is the most common age range. Clinical findings and dermatological pathergy test are important in diagnosis. However, specialist rheumatology doctors are competent in diagnosing and treating Behçet’s Disease.

Panuveitis in the eye (can go up to blindness), ulcerated wounds in the mouth, skin rashes, painful ulcerated wounds in the genital area, thrombosis and aneurysms in the veins, inflammation and vascular occlusion in the lungs, inflammation in the lining of the brain and vascular occlusion, inflammation in the brain parenchyma tissue, ulceration in the digestive tract along the intestines. wounds, involvement in the pericardium, giant intra-cardiac clots are among the clinical findings that can be seen.

Treatment

There is currently no treatment that will completely eradicate the disease. The goal of treatment is to eliminate inflammation and prevent damage that may occur. Thus, the deterioration of the quality of life of the person is prevented, complications such as disability and blindness are tried to be stopped. Various drugs are available. They are applied topically on wounds, orally or intravenously, or they are applied into the skin, which we call subcutaneous. Steroids are also included in the treatment of this disease, and various disease-modifying antirheumatic agents and colchicine are also found in the treatment. Which drug will be chosen, how it will be administered, how long the treatment will take depends on the condition of the patient. Since many organs and systems are involved, evaluation and treatment recommendations of various branch physicians can be obtained with a multidisciplinary approach. However, the physicians who will diagnose the disease, determine the follow-up scheme and arrange the treatment are internal medicine-rheumatology specialists. It should be noted that although the treatment is effective, exacerbations may occur.

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