Ulcers

Review Article

Ulcerative Lesions in Behcet's Disease

Table 2

Therapy of types/condition and Floor Chart of 1st, 2nd, 3rd line medicine.
(a) Topical treatments of ulcerations
TreatmentDoseUsed as first-line therapyUsed as alternative therapy
Topical steroids3 times a day topicallyOral and genital ulcers 
%5 Amlexanox paste4/day topicallyOral ulcers 
Sucralfate suspension4/day topically for 3 monthsOrogenital ulcers 
Triamcinolone acetonide 40 mg ampuleIntralesionally 5 mg/mLSevere orogenital ulcers 
Lidocaine %2–54/day topically as mouthwashes, before meals Severe and multiple oral ulcers in Behçet’s patients with insufficients oral intake by pain,  
Chlorhexidine gluconate rinses %1-2Topically as mouthwashesOral ulcers 
Tetracycline250 mg in 5 mL water solution, held in mouth for 2 min once a dayOral ulcers
rhGM-CSF 300 μg ampuleIntralesionally injection in every 2 weeksLarge genital ulcers
(b) Systemic treatments
TreatmentDoseUsed as first-line therapyUsed as alternative therapy
Systemic steroids5–100 mg/day orallyOrogenital and gastrointestinal ulcerations
Colchicine0.5–1.5 mg/day orallyOral and genital ulcers 
Thalidomide 100–300 mg/day orallyOrogenital ulcers
Dapsone100 mg/day orallyOral and genital ulcers
Pentoxifylline 300 mg/day orallyOrogenital and leg ulcers
Levamisole150 mg in 3 doses/day every 2 day 1 weekMucocutaneous ulcers
Penicilline  U/3 weekMucocutaneous ulcers
Azithromycin500 mg 3 times a week for 4weeksMucocutaneous ulcers
Interferon-α5 million U/day im or s.c.Mucocutaneous ulcers
Sulfasalazine1–3 gr/day orallyGastrointestinal ulcers 
SurgeryGastrointestinal ulcers
Combination therapies   
 Penicilline + colchicinePenicilline  U/3 week, colchicine 1.5 mg/dayMucocutaneous ulcers