Behcet's Disease (Behçet's Syndrome)

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Behcet's Disease
Overview

What Is Behcet's Disease

What is Behcet's disease?

The first case of Behcet's disease was reported by Turkish dermatologist Bechet in 1937, which is also the origin of the name of Behcet's disease.

Behcet's disease is also called "Behcet's syndrome" or "mouth-eye-genital syndrome". From the name behind, we can see the manifestations of Behcet's disease: repeated ulceration of the mouth and reproductive organs, blurred vision of the eyes, decreased vision, and skin lesions similar to whelk-like and red induration-like lesions. When the condition is serious, lesions will appear in joints, digestive tract and nervous system, and varicose veins like earthworms will appear in the skin of lower limbs.

It is also called "Silk Road Disease" because of its high incidence in South Korea, Japan, China, Turkey and Iran.

The specific etiology of Behcet's disease is still unclear, and it is likely to occur in young and middle-aged people. There are more male patients than female patients, and the male patients' condition is relatively serious.

At present, Behcet's disease cannot be cured completely and it is easy to relapse. However, regular treatment as early as possible after the diagnosis is conducive to controlling the existing symptoms, preventing and treating important organ damage and slowing the disease progression.

Is Behcet's disease more common?

Rare. The prevalence in China is (13.5–20)/100 000.

Cause

What Is The Cause Of Behcet's Disease

What is the cause of Behcet's disease?

The pathogenesis of Behcet's disease is currently unclear and may be related to genetic, environmental, infectious, immune and other factors, as follows:

  • Heredity: Studies have found that some patients with Behcet's disease have a clear family genetic history.

  • Environment: The incidence and region of Behcet's disease have been existed before, and it mostly occurred in the Mediterranean Sea, Middle East, China and Japan.

  • Infection: Studies have found that Behcet's disease may be related to viral and bacterial infections and may also be related to tuberculosis.

  • Immunity: The body of patients with Behcet's disease produces antibodies against the oral mucosa and blood vessel wall, which means that the oral mucosa and blood vessel wall are labeled as "enemies", making the body's immune system treat them as enemies and attack them, causing lesions in the oral mucosa and blood vessel wall.

What kind of people is Behcet's disease common in?

Behcet's disease mainly occurs in young and middle-aged people aged 16–40 years old. There are more male patients than female patients, and male patients are more prone to ocular, nervous system and vascular lesions, and the condition is generally more serious.

Is there a greater chance of Behcet's disease being passed on to children?

Not much. Although a small percentage of patients with Behcet's disease have a genetic family history, there is currently no information reporting a strong genetic predisposition for Behcet's disease.

Is behcet's disease venereal disease? Is Behcet's disease contagious?

Although Behcet's disease has genital ulceration, it is not a venereal disease. Daily intimate contact and sexual contact are not contagious. However, it is recommended that you do not have sex during the period of genital ulceration to prevent further enlargement of the ulceration or septic infection.

Symptom

What Are The Symptoms Of Behcet's Disease

What are the common symptoms and manifestations of patients with Behcet's disease?

Patients with Behcet's disease may have lesions in the oral cavity, genital organs, eyes, skin, joints, digestive tract, blood vessels, nervous system, and other parts, mainly manifested as:

  • Oral and genital ulceration.

  • Blurred vision, eye pain, increased gum, severe vision loss and even blindness.

  • Skin lesions similar to whelk-like and red induration-like.

  • Red, swelling and pain in large joints.

  • Gastrointestinal ulcers, perforations, and even death from massive bleeding.

  • Superficial blood vessels of lower limbs have varices like earthworms and protrude obviously from the skin, which may cause pain when walking. Skin ulceration difficult to heal (thrombophlebitis) may occur at the site of vascular obstruction.

  • Nervous system diseases include headache, numbness and weakness of limbs, hemiplegia, epilepsy, inability to speak, meningitis, etc.

What is the specific oral lesion of Behcet's disease?

Patients with Behcet's disease generally suffer from oral ulceration, which is mainly located in the tongue, lips, gums, gills and other areas. The patients have round or oval ulcerated surfaces, which can be one or more in number, with a clear boundary. If the ulcerated surface is deeper, scars will be left after healing, and the patients will feel great pain. The ones with severe pain will affect eating. Oral ulceration can heal itself within 1–2 weeks generally, but it is prone to repeated attacks, which occur at least three times a year.

What is the specific lesion of the genital organs of Behcet's disease (such as scrotum, penis, glans penis, labia minora and clitoris)?

About 80% of patients with Behcet's disease will have genital ulceration, which usually occurs after oral cavity or skin lesions. Male genital ulceration mainly occurs in the scrotum, penis and glans penis, with relatively mild symptoms. Female genital ulceration occurs mainly in the vulva, but also in the vagina and cervix, with more severe symptoms. Ulceration can also occur in the anus and rectum of men and women, and genital ulceration is similar to oral ulceration.

What is the skin lesion of behcet's disease specific? How is skin acupuncture reaction to return a responsibility?

The vast majority of patients with Behcet's disease will appear skin lesions, mainly manifested as:

  • Lesions similar to "whelk" appear on the chest and back, and red induration ranging in size from peanuts to quail eggs may appear in front of the legs on both sides, causing pain when pressed by hands.

  • Some patients have positive skin acupuncture reaction, that is, red pimples with a diameter of 2 mm can appear after 24 ~ 48 hours at the pricked part by injecting normal saline into the skin, or directly puncturing the skin with sterile needles, which is very meaningful for diagnosis.

What diseases are common in organs other than mouth, eyes and genitals of patients with Behcet's disease?

  • Gastrointestinal lesions may cause stomach discomfort, stomach pain, bloody stools, etc. In severe cases, peptic ulcer and perforation may occur, and even death may result from massive bleeding.

  • The incidence of pulmonary lesions is low, and symptoms such as hemoptysis may occur.

  • Occasionally, the kidney will have pathological changes, such as hematuria and waist discomfort.

  • Occasionally, there will be myocarditis such as palpitation, blackness and fainting.

  • Epididymitis may cause discomfort and obvious pain in scrotum.

Is Behcet's disease incurable?

Behcet's disease is easy to recur and has a long course, but it is not a terminal disease. Once the diagnosis is correct, standardized treatment as early as possible will help to slow down the progress of the disease.

Can Behcet's disease become cancerous?

No.

Detect

How To Check For Behcet's Disease

What tests are needed to diagnose Behcet's disease?

The diagnosis of Behcet's disease is mainly based on clinical symptoms and there are no specific laboratory abnormalities. In the active stage of the disease, there may be increased erythrocyte sedimentation rate and increased C-reactive protein. Rheumatoid factor, anti-nuclear antibodies and other tests can help in the differential diagnosis.

In the early stage of Behcet's disease, only when the mouth ulcerates, how can it be distinguished from recurrent aphtha?

Recurrent aphthous stomatitis, also known as recurrent oral ulcer (aphthous ulcer), is more common in young women. Dyspepsia, fever, lack of sleep, excessive fatigue, high work pressure, and changes in menstrual cycles can all cause recurrent aphthous stomatitis. aphthous stomatitis is generally smaller and more frequent in number, and it can resolve itself after about ten days, accompanied by fever, pharyngitis, and enlarged lymph nodes.

In the early stage of Behcet's disease, only genital ulceration occurs. How can it be distinguished from genital herpes?

Genital herpes has a clear history of impure sexual intercourse and the diseased skin is initially a small blister that gradually breaks apart, and antiviral therapy is effective. See regular specialist, differentiate not difficult.

Prevention

How To Prevent Behcet's Disease

Can a person with Behcet's disease use prenatal care to ensure their child is not ill?

No. At present, the exact gene of Behcet's disease is not clear, so prenatal examination cannot be used to evaluate whether children will suffer from Behcet's disease.

Treatment

How To Treat Behcet's Disease

Which department should I use for Behcet's disease?

Behcet's disease is an autoimmune disease, and skin lesions will appear in most patients, so it can be hung in the Department of Rheumatology and Immunology or Dermatology.

How to treat Behcet's disease?

  • Anti-inflammatory and immunosuppressive therapy: The main drugs include:

    • Glucocorticoid: mainly used for the treatment of acute eye lesions; The oral cavity and genital ulceration is large and deep in area, and hard to endure pain; Patients with nervous system diseases; Lung, kidney, digestive tract lesions and the condition is more serious. Besides, regular reexamination of blood glucose and electrolytes during glucocorticoid treatment is needed to prevent serious side reactions.

    • Immunosuppressive agents: Common drugs include cyclophosphamide, azathioprine, and cyclosporine. When the condition of Behcet's disease further aggravates or the effect of glucocorticoid treatment is unsatisfactory, immunosuppressive agents can be used instead or in combination. Regular reexamination of liver and kidney function is required during medication. It should never be used by pregnant or lactating women.

    • Nonsteroidal anti-inflammatory drugs: ibuprofen, naproxen, or selective COX-2 inhibitors. Patients with fever, severe joint symptoms and obvious erythema and pain in skin nodules can be treated with glucocorticoids. Attention should be paid to the occurrence of gastrointestinal ulcers.

    • Thalidomide: has good curative effect on oral cavity and genital ulcer. This medicine can cause fetal deformity, and must not be used by women who intend to give birth recently or by pregnant women.

    • Colchicine: significant for ocular and skin lesions. Regular reexamination of liver and kidney function is needed.

  • Symptomatic support treatment:

    • Analgesic treatment: oral ulcer pain difficult ninja, can be oral analgesics;

    • Topical application to relieve symptoms: when genital ulceration occurs, the local part can be cleaned with potassium permanganate solution for external application, followed by external application of antibiotics such as mupirocin ointment; patients with mild ocular and oral lesions can be treated with hormone ointment for external application.

    • Treatment of thrombotic disorders: Prevention of venous thrombosis events in Behcet's disease is achieved by controlling systemic inflammation rather than initiating initial anticoagulation. However, in the event of venous thrombosis, anticoagulation should be performed using standard methods. Thrombolysis can be intravenous streptokinase, anticoagulation can be subcutaneous injection of low molecular weight heparin, oral warfarin.

Do people with Behcet's disease need to be hospitalized?

Patients with mild Behcet's disease (such as those with only oral ulceration, genital ulceration and skin lesions) can be treated in an outpatient setting; Moderate to severe patients (such as those with gastrointestinal, ocular, cardiac, pulmonary, joint, nervous system lesions) require hospitalization.

Can Behcet's disease be completely cured?

At present, Behcet's disease cannot be cured completely, and there is no specific treatment. Moreover, it is easy to relapse. However, once diagnosed as Behcet's disease and given early and effective treatment, Behcet's disease can be completely controlled and does not continue to develop, without complications, does not affect daily life.

Is Behcet's disease easy to relapse after its condition is controlled?

Behcet's disease easily relapses, and its remission is characterized by alternating recurrence with remission lasting from several weeks to several years, which varies from person to person.

What is the effect of Behcet's disease if it is not treated?

  • If the canker of oral cavity and genital part is deeper, can leave scar, can cause big haemorrhage even.

  • Eye lesions can cause decreased vision or even inability to see anything.

  • Nervous system diseases include limb numbness and weakness, hemiplegia, epilepsy, inability to speak, meningitis, mental abnormalities, and brain stem and spinal cord diseases can lead to disability and even death.

  • Joint lesions will appear red pain, affect walking.

  • Gastrointestinal lesions can ulcerate, perforate, and even die from massive hemorrhage.

  • Venous thrombosis can occur in vascular lesions, and blockage of the lungs can lead to chest pain, dyspnea, and even death due to massive hemoptysis.

Are these lesions of Behcet's disease easy to recover?

Most patients with Behcet's disease recover well. If diseases occur in eyes, nervous system, digestive tract, and lung, the recovery is not good and even death may occur.

Life

What Should Patients With Behcet' S Disease Pay Attention To In Life

Can patients with Behcet's disease have children?

Although patients with Behcet's disease may have genital ulceration, epididymitis, etc., they can give birth when the condition is well controlled and stable. Female patients with Behcet's disease can even become pregnant with the disease, but this needs to be done under the strict guidance of a doctor. There are many female patients who become pregnant with the disease and give birth to a healthy baby.

What should be noticed in diet of patients with Behcet's disease?

  • Avoid barbecue, greasy, and spicy excitant diet, in case of oral and digestive tract lesions.

  • Eat more fresh vegetables, fruits, nutrition should be balanced.

  • If a food can induce or aggravate the condition, should pay attention to diet.

  • Avoid eating food that is too hot or too cold to damage your mouth.

How should patients with Behcet's disease exercise?

Patients with Behcet's disease can often do aerobic exercise such as jogging, cycling, etc., to improve the systemic blood circulation. At the beginning of the exercise, you should warm up slowly. The intensity of the exercise should not be too strong. Every time you exercise for half an hour to one hour, you should not make your body sweat too much. After the exercise, you should not sit down and take a long drink of water. You should gradually and slowly finish the exercise and give your heart and whole body an adaptation process.

What should be noticed in the life of patients with Behcet's disease?

  • Optimistic, cheerful, keep a cheerful mood.

  • Regular life, combination of work and rest, and pay attention to rest when the illness is serious.

  • Avoid skin injury, breakage and infection.

  • Pay attention to oral health, often gargle.

  • Don't wear contact lenses and avoid direct sunlight.

  • Quit smoking and limit drinking.

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