Nicotine-patch therapy on mucocutaneous lesions of Behcet's disease: a case series

Objective. We report the use of nicotine-patch therapy on active mucocutaneous lesions of Behcet's disease (BD). Methods. Five BD ex-smoker patients with refractory active mucocutaneous manifestations were treated with nicotine patches for 6 months. Results. Four out of five patients quickly responded to nicotine-patch therapy and experienced a complete regression of mucocutaneous lesions. Other manifestations of BD did not respond and new manifestations appeared during this treatment. One patient had no benefit from therapy but on restarting smoking it was promptly effective. Conclusions. Mucocutaneous lesions associated with BD may be modulated by smoking. Both smoking and nicotine-replacement therapy may be efficacious not only on oral aphthae, but also on other mucocutaneous manifestations, whereas the efficacy in the treatment and prevention of other systemic manifestations of BD is not proven. At least in ex-smokers, nicotine in its pure form is well tolerated and its use could be justified in selected cases of BD with predominant and recurrent refractory mucocutaneous manifestations.