Behçet's disease is an autoimmune disease that causes inflammation and affects blood vessels. People with this disease often experience recurring inflammatory episodes in various organs, including the mouth, skin, eyes, joints, digestive system, and central nervous system.

People with Behçet's disease commonly develop mouth ulcers. These ulcers can appear on the cheeks, tongue, lips, and throat inside the mouth and can be quite painful.

What Causes Behcet's Disease?

The exact cause of Behçet's disease is unknown. However, experts believe it results from an abnormal immune system response. The immune system normally functions to protect the body from infection, but in people with Behçet's disease, the immune system mistakenly begins to attack the body's own tissues.

Genetic factors are also thought to play a role in the development of Behçet's disease. It has been determined that certain genes may increase susceptibility to the disease and that it is more common in individuals with a family history of the disease. However, it is difficult to say that genetic factors alone cause the disease. Environmental triggers are thought to be influential in the development of the disease in individuals with a genetic predisposition. For example, factors such as infections, smoking, and stress are thought to be triggering factors for Behçet's disease.

Who usually suffers from Behçet's disease?

Behçet's disease can occur in people of all ages and genders, but it usually begins in young adults (between the ages of 20 and 40).

Behçet's disease has been linked to a genetic predisposition. People with a family member with Behçet's disease are at higher risk of developing the disease. However, the disease often results from a combination of factors, so it's difficult to say that genetic predisposition alone is the cause of the disease.

Behçet's disease can have varying prevalence rates among different ethnic groups. For example, it is more common in Türkiye, the Middle East, and Japan, while it is less common in Europe and the United States. However, in recent years, Behçet's disease has become more prevalent worldwide, and its diagnosis is increasing in different geographic regions.

What are the symptoms of Behcet's disease?

Behçet's disease can have a variety of symptoms that can affect different organs. Symptoms can vary from person to person and can change over time. Some common symptoms of Behçet's disease include:

• Mouth ulcers: The most characteristic symptom of Behçet's disease is mouth ulcers. They are usually painful and recurring. They can appear on the tongue, cheeks, lips, or throat.
• Eye problems: Inflammation of the eyes (uveitis) may occur. Symptoms include redness, pain, blurred vision, and photophobia (sensitivity to light). In severe cases, vision loss may also occur.
• Skin problems: Various skin lesions and rashes can occur in Behçet's disease. These are particularly noticeable on the hands and feet, genital area, around the knees, and trunk.
• Joint pain: Symptoms such as joint pain, swelling, and stiffness may occur. It usually affects the larger joints.
• Digestive system problems: Behçet's disease can sometimes affect the digestive system. Symptoms such as abdominal pain, nausea, vomiting, diarrhea, or bloody stools may occur.
• Brain and nervous system symptoms: In rare cases, Behçet's disease can affect the brain and nervous system. Symptoms such as headache, brain inflammation (encephalitis), paralysis, balance problems, and neurological disorders can occur.

The symptoms listed below are common symptoms of Behçet's disease. However, symptoms can vary depending on the severity of the disease, the organs affected, and the individual. It's important to consult a doctor for diagnosis and treatment.

How is Behcet's disease diagnosed?

Diagnosis of Behçet's disease is based on the patient's symptoms, clinical findings, and specific diagnostic criteria. Because Behçet's disease can have symptoms that can be confused with other similar conditions, some methods used to diagnose Behçet's disease include:

• Patient history and physical examination: The doctor will thoroughly evaluate the patient's symptoms and history. A detailed interview will be conducted to observe the typical signs of Behçet's disease, including the duration, severity, and recurrence of symptoms. They will also perform a physical examination to assess for mouth ulcers, skin lesions, joint swelling, or other symptoms.
• Diagnostic criteria: Diagnosis can be made based on the criteria established by the International Behçet's Disease Study Group. These criteria require the presence of specific symptoms and signs. For example, a diagnosis can be made with at least two symptoms (e.g., mouth ulcers, eye problems, genital ulcers, a positive skin pathergy test) or with at least one of the main symptoms (e.g., mouth ulcers and eye problems).
• Laboratory tests: Laboratory tests play a supporting role in the diagnosis of Behçet's disease. Blood tests may be performed to measure inflammatory markers (sedimentation rate, C-reactive protein), assess immune system response, or exclude other autoimmune diseases. Specialized tests, such as a skin pathergy test, may also be performed.
• Imaging tests: Imaging tests may be used to detect inflammation or damage in the eyes or other organs. Eye examination, ophthalmoscopy, and slit-lamp microscopy can be used to assess eye involvement. Ultrasound, MRI, or other imaging methods may also be used to detect inflammation in other organs.

A diagnosis of Behçet's disease is made by a specialist physician based on symptoms, clinical findings, and the results of the tests mentioned above. The diagnostic process can often be lengthy and requires a comprehensive evaluation to rule out other conditions.

How is Behcet's disease treated?

Treatment for Behçet's disease depends on the severity of symptoms, the organs affected, and the patient's overall health. Treatment generally aims to control symptoms, reduce inflammation, and prevent complications. Some methods used in the treatment of Behçet's disease include:

Drug Therapy:

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs): May help reduce pain, inflammation, and fever.
• Corticosteroids: Used to relieve severe symptoms. However, low doses and short-term use are preferred because long-term use can have side effects.
• Immunosuppressants: These can help reduce inflammation by suppressing the immune system. Medications such as methotrexate, azathioprine, and cyclosporine may be used.
• Biological Agents: Biological agents have also been used in the treatment of Behçet's disease in recent years. These drugs, administered by infusion or injection, work to control inflammation by affecting a targeted portion of the immune system. For example, TNF-alpha inhibitors (adalimumab, infliximab) are included in this group.
• Oral Care: Mouthwashes, topical anesthetics, and anti-inflammatory medications can be used to treat mouth ulcers caused by Behçet's disease. Regular dental cleanings and oral hygiene are also important.
• Eye Care: Treatment should begin early in patients with eye involvement due to Behçet's disease. Eye drops, corticosteroid injections, or immunosuppressant medications may be used to treat eye problems.
• Surgical Intervention: Some complications of Behçet's disease may require surgical intervention. For example, in cases of severe eye involvement, intraocular injections or retinal surgery may be performed.

Treatment for Behçet's disease can vary depending on the patient's condition and the severity of symptoms. The goals of treatment are to control symptoms, prolong periods of remission, and prevent complications.

Do Behçet's sores leave scars?

Mouth sores caused by Behçet's disease generally do not leave a scar when they heal. These sores are ulcers that form on the oral mucosa and usually heal on their own within a few weeks. As the sores respond to treatment, their frequency and severity may decrease.

However, in some cases, mouth sores can be deep or extensive and may require longer healing times. In these cases, a small scar or slight discoloration in the wound area may appear as the wound heals. However, these scars are usually not permanent and will fade or disappear completely over time.

Skin lesions associated with Behçet's disease can also leave scars. Mild discoloration, pigmentation, or hyperpigmentation may occur, particularly as skin pustules or ulcers heal. However, skin lesions tend to improve over time, and scars become less visible.

In any case, whether or not the wounds resulting from Behçet's disease leave scars may vary from person to person.

Is Behçet's disease contagious?

No, Behçet's disease is not contagious. Behçet's disease is a chronic inflammatory condition and is classified as an autoimmune disease. This disease occurs when the immune system attacks body cells. While the exact cause is unknown, factors such as genetic predisposition, environmental factors, and immune system disorders are thought to play a role.