Arzu Kilic

By Arzu Kılıç

Alopecia areata (AA) is a common and complex T-cell–mediated inflammatory disorder. It may be patchy (localized), involve the entire scalp (alopecia totalis) or entire body (alopecia universalis). Alopecia totalis and universalis are often difficult to treat. Although many therapeutic options currently exist in alopecia areata, none of them are curative or preventive. Besides, none of them are approved by Food and Drug Administration (FDA). The disease unfortunately has an unpredictable course. The factors indicating a poor prognosis are the extent of hair loss at the presentation, long duration of the disease, and ophiasis pattern of hair loss. There are only a few randomized controlled studies conducted on recalcitrant AA. Recent research on immunology of hair follicle and recent developments in immunopathogenesis, together with the shared pathways of the disease with other autoimmune disorders, led investigators to focus on novel therapies that target specific immunological pathways. Herein, we will review shortly the current treatment options in recalcitrant alopecia areata based on recently published studies and then will focus on the recently developed broad-spectrum and targeted therapeutics.

Part of the book: Hair and Scalp Disorders

By Arzu Kilic

Behçet’s disease is a chronic inflammatory disease with an unpredictable course. The disease may affect almost all organ systems resulting with significant organ-threatening morbidity and mortality. Mucocutaneous lesions mostly constitute the initial symptoms of the disease and precede other manifestations. As there is yet no pathognomonic diagnostic test in Behçet’s disease, the recognition of cutaneous and mucosal findings let the physician enable an earlier diagnosis and earlier treatment. Therefore, the purpose of this chapter is to emphasize the importance of the mucocutaneous manifestations of Behçet’s disease and to review the mucocutaneous lesions in detail. Finally, childhood Behçet’s disease, differential diagnosis and treatment of mucocutaneous manifestations will be briefly reviewed.

Part of the book: Behcet's Disease

By Arzu Kilic

Pemphigus is a group of autoimmune blistering disorders associated with autoantibodies against the keratinocyte cell surface. Pemphigus has three major variants: pemphigus vulgaris (PV), pemphigus foliaceus (PF), and paraneoplastic pemphigus (PNP) which all have further subtypes. The variants of pemphigus are classified depending upon the clinical and histological features, immunofluorescence staining pattern, and autoantibody profile of the disease. The onset and course of pemphigus appear on the basis of interaction between genetic predisposition and various triggering factors. Pemphigus vulgaris is the most commonly seen and representative clinical form of pemphigus. Together with clinical manifestations, the histopathological and immunopathological data support the diagnosis. As though some pemphigus variants, particularly pemphigus vulgaris and paraneoplastic pemphigus, have a mortality risk, early diagnosis is necessary and onset of treatment should be promptly initiated. In this chapter, firstly, classification of pemphigus is described. After then, clinical features, histopathological and immunopathological findings, target antigens, etiopathogenesis and comorbidities of each pemphigus variant are discussed briefly.

Part of the book: Autoimmune Bullous Diseases