{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:12:17Z","timestamp":1785510737317,"version":"3.56.0"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Autoimmune bullous diseases (\n                      <jats:styled-content style=\"fixed-case\">AIBD<\/jats:styled-content>\n                      ), Stevens\u2010Johnson syndrome and toxic epidermal necrolysis (\n                      <jats:styled-content style=\"fixed-case\">SJS<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>\n                      ) and erythema multiforme (\n                      <jats:styled-content style=\"fixed-case\">EM<\/jats:styled-content>\n                      ) 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      We sought to establish an consensus on the management of oral involvement of\n                      <jats:styled-content style=\"fixed-case\">AIBD<\/jats:styled-content>\n                      ,\n                      <jats:styled-content style=\"fixed-case\">SJS<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">EM<\/jats:styled-content>\n                      using the Delphi method.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2010TEN; specific considerations for EM and SJS\u2010TEN. Participants rated the level of appropriateness of each statement. Results were analysed using the RAND\/UCLA Appropriateness Method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2010specific severity scoring was recommended to guide treatment and monitor response. For active oral AIBD, experts recommended moderate\u2010to\u2010super 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\u2010TEN, recommendations included regular lip care with gentle debridement of haemorrhagic crusts and application of soft paraffin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This Delphi sets out a broad framework for the management of oral involvement in AIBD, SJS\u2010TEN and EM, to be adapted by a multidisciplinary team, for both acute and long\u2010term management of these conditions. It may help to standardize the management of oral manifestations of these conditions in future multicentre studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.70578","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T07:08:36Z","timestamp":1784704116000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Expert consensus on oral management in autoimmune bullous diseases, erythema multiforme and\n                    <scp>SJS<\/scp>\n                    \/\n                    <scp>TEN<\/scp>"],"prefix":"10.1111","author":[{"given":"Shalini","family":"Nayee","sequence":"first","affiliation":[{"name":"Department of Oral Medicine, Guy's Hospital Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8457-6792","authenticated-orcid":false,"given":"Molly","family":"Harte","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Guy's Hospital Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5383-7096","authenticated-orcid":false,"given":"Saskia","family":"Ingen\u2010Housz\u2010Oro","sequence":"additional","affiliation":[{"name":"Dermatology Department, AP\u2010HP Henri Mondor hospital  Cr\u00e9til France"},{"name":"Reference center for toxic bullous dermatoses and severe drug reactions TOXIBUL  Cr\u00e9teil France"},{"name":"AIBD\u2010ToxiTEN group of the ERN\u2010skin Univ Paris Est Cr\u00e9teil, EpiDermE  Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milad","family":"Ameri","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8279-0506","authenticated-orcid":false,"given":"Sarah","family":"Walsh","sequence":"additional","affiliation":[{"name":"AIBD\u2010ToxiTEN group of the ERN\u2010skin Univ Paris Est Cr\u00e9teil, EpiDermE  Cr\u00e9teil France"},{"name":"Department of Dermatology King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5734-0255","authenticated-orcid":false,"given":"Pascal","family":"Joly","sequence":"additional","affiliation":[{"name":"AIBD\u2010ToxiTEN group of the ERN\u2010skin Univ Paris Est Cr\u00e9teil, EpiDermE  Cr\u00e9teil France"},{"name":"Department of Dermatology Rouen University Hospital, INSERM U1234, Normandie University  Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ardern\u2010Jones","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospitals Southampton NHS Foundation Trust  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlaho","family":"Brailo","sequence":"additional","affiliation":[{"name":"University of Zagreb School of Dental Medicine University Clinical Hospital Centre Zagreb  Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Charlotte","family":"Brueggen","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Zurich  Zurich Switzerland"},{"name":"Faculty of Medicine University of Zurich  Zurich Switzerland"},{"name":"Department of Dermatology Medical University of Vienna  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Bunker","sequence":"additional","affiliation":[{"name":"Department of Dermatology University College London Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgical Oncology Guy's Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Carrozzo","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, School of Dental Sciences University of Newcastle upon Tyne  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ser\u2010Ling","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospitals Birmingham NHS Foundation Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Creamer","sequence":"additional","affiliation":[{"name":"Department of Dermatology King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Culton","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantina","family":"Delli","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University of Groningen, University Medical Centre Groningen  Groningen the Netherlands"},{"name":"Center for Dentistry and Oral Hygiene University Medical Center Groningen and University of Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio","family":"Diniz\u2010Freitas","sequence":"additional","affiliation":[{"name":"Special Care Dentistry Unit, School of Medicine and Dentistry University of Santiago de Compostela  Santiago de Compostela Spain"},{"name":"Medical\u2010Surgical Dentistry Research Group (OMEQUI) Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC)  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roni","family":"Dodiuk\u2010Gad","sequence":"additional","affiliation":[{"name":"Department of Dermatology Emek Medical Center  Afula Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie\u2010Myriam","family":"Dridi","sequence":"additional","affiliation":[{"name":"Department of Periodontology Fondation Universit\u00e9 C\u00f4te d'Azur, Nice  Provence\u2010Alpes\u2010C\u00f4te d'Azur France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Laure","family":"Ejeil","sequence":"additional","affiliation":[{"name":"Department of Odontology Bretonneau Hospital AP\u2010HP  Paris France"},{"name":"Faculty of Odontology, Department of Oral Surgery Paris Cit\u00e9 University  Montrouge France"},{"name":"Inserm UMR1333 Oral Heath  Montrouge France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"French","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital, LMU Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krisztian","family":"Gaspar","sequence":"additional","affiliation":[{"name":"Division of Dermatological Allergology, Faculty of Medicine University of Debrecen  Debrecen Hungary"},{"name":"Department of Dermatology, Faculty of Medicine University of Debrecen  Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Higham","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine Birmingham Dental Hospital and School of Dentistry  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Horvarth","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Centre Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Hullah","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Guy's Hospital Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Jurge","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine Sheffield Teaching Hospitals NHS Foundation Trust and University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roddy","family":"McMillan","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine &amp; 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