First Line

• Treatment of any underlying or causative disease
• Withdrawal of any drugs that might be the cause
• For mild cases, symptomatic treatment is sufficient.

• Steroid use is controversial. Patients who have recurrent herpes-induced erythema mulitforme may benefit from acyclovir, which reduces the number of herpetic episodes. Other causative infections should be treated appropriately.
• Contraindications: Some underlying infections or health problems, such as diabetes, may contraindicate the use of steroids.
• Precautions: Refer to the manufacturer's profile of each drug.
• Significant possible interactions: Refer to the manufacturer's profile of each drug.

Additional Treatment

General Measures

• For more severe cases, be meticulous regarding wound care and the use of Burow's solution or Domeboro solution dressings.
• Oral lesions can be treated with mouthwashes with warm saline or a solution of diphenhydramine, lidocaine (Xylocaine), and Kaopectate to provide symptomatic relief and oral hygiene and to facilitate oral intake.

In-Patient Consideratons

Initial Stabilization
Care at home, unless mouth lesions (i.e. herpes infection) preclude oral intake