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Behcet's Disease: A Contemporary Synopsis

      Editors Plotkin, Calabro, and O'Duffy have compiled a book that is exactly what the title states, but more. After a succinct but enticing chapter on the history of Behçet's disease, the authors delve into epidemiology and lucidly describe the various proposed diagnostic criteria. Three chapters delineate the imbroglio of immunologic aberrancies manifested in this condition, and another three cover hematologic aspects, pathologic changes, and other possible pathogenetic factors. The last-mentioned chapter arouses interest but is of doubtful significance. The remainder of the text provides an exhaustive account of clinical features, an awesome display even to those with a special interest in this medical cornucopia. Behçet's disease challenges lupus in regard to the number of clinical signs and symptoms and rivals neurosyphilis for its variety of neurologic manifestations. A final brief chapter discusses treatment. Its brevity appropriately reflects the current therapeutic dilemma—;reliance on corticosteroids and alkylating agents to try to suppress the serious consequences of the inflammation. Any disease for which we are still considering colchicine or levamisole hydrochloride for therapy and awaiting controlled studies on the use of dapsone is de facto poorly treated. The author mentions the sometimes remarkable effect of thalidomide on mucocutaneous lesions; unfortunately, the drug will probably never be available to patients in the United States because it remains a shining monument to the success of the conservative policies of the Food and Drug Administration.
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