Behçet's disease: an algorithmic approach to its treatment

Arch Dermatol Res. 2009 Oct;301(10):693-702. doi: 10.1007/s00403-009-0990-2. Epub 2009 Aug 21.

Abstract

Behçet's disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology with the clinical features of mucocutaneous lesions, ocular, vascular, articular, gastrointestinal, urogenital, pulmonary, and neurologic involvement. Mucocutaneous lesions figure prominently in the presentation and diagnosis, and may be considered the hallmarks of BD. Therefore, their recognition may permit earlier diagnosis and treatment. Although, the treatment has become much more effective in recent years, BD is still associated with severe morbidity and considerable mortality. The main aim of the treatment should be the prevention of irreversible organ damage. Therefore, close monitoring, early and appropriate treatment is mandatory to reduce morbidity and mortality. We reviewed the current state of knowledge regarding the therapeutic approaches for BD and designed a stepwise, symptom-based, algorithmic approach, mainly based on controlled studies and our clinical experience in this field to provide a rational framework for selecting the appropriate therapy along the various treatment choices.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Behcet Syndrome / immunology
  • Behcet Syndrome / pathology
  • Behcet Syndrome / physiopathology
  • Behcet Syndrome / therapy*
  • Blood Vessels / drug effects
  • Blood Vessels / immunology*
  • Blood Vessels / pathology
  • Clinical Trials as Topic
  • Cyclophosphamide / therapeutic use
  • Cyclosporine / therapeutic use
  • Humans
  • Immunosuppression
  • Mucous Membrane / drug effects
  • Mucous Membrane / immunology*
  • Mucous Membrane / pathology
  • Multiple Organ Failure / prevention & control
  • Practice Guidelines as Topic
  • Skin / drug effects
  • Skin / immunology*
  • Skin / pathology

Substances

  • Adrenal Cortex Hormones
  • Cyclosporine
  • Cyclophosphamide