%0 Journal Article
%T Histopathological Evaluation of Beh£¿et's Disease and Identification of New Skin Lesions
%A £¿zg¨¹r G¨¹nd¨¹z
%J Pathology Research International
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/209316
%X Beh£¿et's disease (BD) is a multisystemic, relapsing inflammatory disorder with an obscure etiology and pathogenesis. Diagnosis depends on the clinician's ability to identify a group of nonspecific mucocutaneous lesions, which also manifest in a number of other diseases. In recent years, there has been an increase in the studies focusing on the histopathological aspects of Beh£¿et's disease diagnostic mucocutaneous lesions. Their results emphasize the value of histopathology and direct immunofluorescence (DIF) in the differential diagnosis of Beh£¿et's disease. 1. Introduction After seventy-four years, since Dr. Hulusi Beh£¿et had published his classic paper describing the three major signs [1], BD are still an enigma for clinicians and researchers. Almost all aspects of BD is a source of debate and even its diagnostic criteria, classification, and pathogenesis are controversial [2¨C4]. In the last two decades, extensive studies have been conducted to reveal the nature of BD. In the light of these studies, BD is now recognized as a chronic, multisystemic vasculitis [2, 5¨C7]. Whether this vasculitis is a result of autoimmunity is controversial [2, 3], but there is increasing evidence indicating the possible role of immunologic mechanisms in the pathogenesis. Evaluation of lesion-free skin and mucocutaneous lesions of patients with BD patients by DIF reveals immunoreactant deposits on the vessel walls [8¨C11]. Also, elevated serum levels of several proinflammatory cytokines (IL-1, IL-4, IL-6, TNF-¦Á, etc.) have been reported in these patients [12]. A special subgroup of T lymphocytes (¦Ã¦Ä T lymphocytes), which play an important role in mucosal immunity, are found to be present in the increased numbers in circulation and mucosal lesions of patients [13]. Several research groups found out that cultured ¦Ã¦Ä T lymphocyte cells proliferate when stimulated with mycobacterial heat shock proteins and products of several oral pathogen microorganisms [13, 14]. Correlation between the hyperactive state of neutrophils and BD activity is another well-known fact. The underlying mechanism is unknown. Antigen-presenting cell and T-lymphocyte-derived cytokines and chemokines are believed to be responsible for neutrophiles hyperreactivitiy [15]. BD is mostly encountered in the Mediterranean and Middle and Far East countries, Turkey having the highest prevalence with 80¨C420£¿cases/100.000 [3, 16]. Genetic studies show statistically significant association with HLA-B51 [17, 18]. Antiendothelial antigens are another immunological anomaly found in BD patients, but there is no solid
%U http://www.hindawi.com/journals/pri/2012/209316/