Faculty Bibliography

To assess the frequency and clinical characteristics of methotrexate (MTX) oral toxicity in rheumatoid arthritis (RA) patients, 51 RA patients receiving MTX and 46 RA patients not receiving MTX were studied. A questionnaire, the credibility of which was tested on four separate patient groups including a group with Behcet's Syndrome, was used as a tool to determine the prevalence of stomatitis by a blind observer. In this first controlled study of the oral toxicity of MTX, prevalence of stomatitis was found in 37.2% in the group taking MTX and 19.5% in the group not taking MTX (P = 0.054). No statistical differences were detected with respect to number, duration, frequency, and site of stomatitis. Two of the 51 MTX taking patients temporarily reduced their MTX dosage and only one patient temporarily terminated MTX treatment. MTX and toxicity is usually of no major clinical concern in the treatment of RA.

OBJECTIVE: The role of autoimmune mechanisms in Behcet's syndrome (BS) is debated. Sjogren's syndrome (SS) accompanies most autoimmune diseases. Thus we investigated the prevalence of SS in BS in a formal protocol. METHODS: The study was conducted in 2 phases. During the first phase subjective symptoms of dryness were blindly assessed by questionnaires and Schirmer I and Saxon tests were done in 67 patients with BS and 100 healthy and diseased controls. During the 2nd phase 30 patients with BS and 19 with rheumatoid arthritis (RA) had salivary gland biopsies along with rose bengal dye, Schirmer I and tear breakup time tests. RESULTS: During the first phase only patients with primary SS had significantly abnormal findings. However during the 2nd phase pathologic changes in salivary gland biopsies and positive RB tests were highly significantly more prevalent among patients with RA. CONCLUSION: SS is not a feature of BS.

Sebum production is under hormonal control. We had shown that male sex is associated with more severe disease in Behcet's syndrome and the acneiform skin lesion of this disorder is not different from ordinary acne, an androgen-dependent lesion. Sebum excretion rate was higher in patients with Behcet's syndrome than in healthy controls, children and patients with ankylosing spondylitis. On the other hand, patients with rheumatoid arthritis had high levels of sebum excretion rate comparable to those found in patients with acne vulgaris. These suggest the presence of a sebotrophic hormone and/or other hormonal effects in Behcet's syndrome and rheumatoid arthritis.