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Behçet Disease: Recommendation for Clinical Management of Mucocutaneous Lesions

Lin, Pin MD; Liang, George MD

JCR: Journal of Clinical Rheumatology: December 2006 - Volume 12 - Issue 6 - pp 282-286
doi: 10.1097/01.rhu.0000249894.03016.de
Review

Mucocutaneous lesions are the most common manifestation of Behçet disease. These lesions can often become refractory to multiple treatments and present challenges to physicians. In this article, different treatments for mucocutaneous lesions in Behçet disease are reviewed and discussed. Topical or intralesional corticosteroids, oral pentoxifylline, sucralfate, dapsone, colchicine, and systemic low-dose corticosteroids, used either alone or in combination, are safe and having varying evidence for effect in mild to moderate mucocutaneous disease. Azathioprine or methotrexate can be used if the lesions are refractory to the previously mentioned therapies. Tumor necrosis factor (TNF) inhibitors such as infliximab or etanercept should be considered as the next step in the treatment if azathioprine or methotrexate fails. Tacrolimus, cyclosporine, and interferon-alpha-2a should be used generally only if TNF inhibitors have failed as a result of their toxicities.

A variety of measures can be tried, including antitumor necrosis factor agents in severe disease. Lesions tend to recur when any of the therapies are discontinued.

From the Department of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Reprints: Pin Lin, MD, Department of Rheumatology, Feinberg School of Medicine, Northwestern University, 240 East Huron Street, Suite 2300, Chicago, IL 60611. E-mail: p-lin3@md.northwestern.edu

© 2006 Lippincott Williams & Wilkins, Inc.