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Lookup NU author(s): Professor Marco CarrozzoORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.Background: Autoimmune bullous diseases (AIBD), Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS-TEN) and erythema multiforme (EM) often present with clinically similar features in the oral mucosa: classically widespread mucosal erosions or ulceration. Despite this, there are no formalized guidelines for the specific management of the oral manifestations of these conditions. Objectives: We sought to establish an consensus on the management of oral involvement of AIBD, SJS-TEN and EM using the Delphi method. Methods: Participants were sent a survey comprising 62 statements organized into 6 categories: general oral and dental recommendations; disease severity scoring; topical therapies for active oral involvement in AIBD; systemic therapies for active oral involvement in AIBD; additional considerations for inpatient care of AIBD, EM, SJS-TEN; specific considerations for EM and SJS-TEN. Participants rated the level of appropriateness of each statement. Results were analysed using the RAND/UCLA Appropriateness Method. Results: 34 experts, primarily Oral Medicine clinicians and Dermatologists, completed the survey. Consensus was achieved for 58 (93.5%) statements after a single round. General recommendations included rigorous oral hygiene and regular dental/periodontal care. Disease-specific severity scoring was recommended to guide treatment and monitor response. For active oral AIBD, experts recommended moderate-to-super potent topical corticosteroids, guided by severity and site of oral disease. For inpatients, supported oral hygiene, regular topical anaesthetics and nutritional support for impaired intake were recommended. For acute EM and SJS-TEN, recommendations included regular lip care with gentle debridement of haemorrhagic crusts and application of soft paraffin. Conclusions: This Delphi sets out a broad framework for the management of oral involvement in AIBD, SJS-TEN and EM, to be adapted by a multidisciplinary team, for both acute and long-term management of these conditions. It may help to standardize the management of oral manifestations of these conditions in future multicentre studies.
Author(s): Nayee S, Harte M, Ingen-Housz-Oro S, Ameri M, Walsh S, Joly P, Ardern-Jones M, Brailo V, Brueggen M-C, Bunker C, Carey B, Carrozzo M, Chua S-L, Creamer D, Culton D, Delli K, Diniz-Freitas M, Dodiuk-Gad R, Dridi S-M, Ejeil A-L, French L, Gaspar K, Higham J, Horvarth B, Hullah E, Jurge S, McMillan R, McParland H, Murrell D, Ormond M, Poveda-Gallego A, Samimi M, Schmidt E, Shephard M, Sollecito T, Taylor J, Uzun S, Valiukeviciene S, Willis A, Setterfield J
Publication type: Article
Publication status: Published
Journal: Journal of the European Academy of Dermatology and Venereology
Year: 2026
Pages: epub ahead of print
Online publication date: 22/07/2026
Acceptance date: 31/05/2026
Date deposited: 04/08/2026
ISSN (print): 0926-9959
ISSN (electronic): 1468-3083
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/jdv.70578
DOI: 10.1111/jdv.70578
Data Access Statement: Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.
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