There are several treatment modalities as well as drug combinations, the basic goal for all of them is to start with a moderate to high dose of corticosteroids and adjunctive immunosuppressive drugs and then reduce the amount of drugs to reach a minimun effective maintenance dose. It is advisable that these patients be treated in collaboration with a dermatologist in order to closely monitor the patientıs response and tolerance to the medications due to the potential for severe side effects. The following treatment protocols are presented here only for the purpose of information for the general practitioner and not as a treatment recommendation to be used by dentists for patients with PV.
Dental management of oral lesions includes the treatment of active periodontal disease and the use of chlorhexidine mouth rinses to minimize the initiation of new bullae by mechanical oral hygiene procedures such as heavy tooth brushing.Other topical steroids can be prescribed such as:
Clobetasol (Temovate) 0.05%
Halobetasol (Ultravate) 0.05%
NOTE: Any of these topical agents should be mixed 1:1 in Orabase to facilitate adhesion.
Custom-made soft plastic applicator trays, which hold these topical steroids, have been used by several authors to treat gingival lesions of PV and other vesiculo-bullous diseases of the oral cavity.
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