Erythema Multiforme

• Topical therapy (compounded rinses) • Option 1
– Diphenhydramine 200 mg, viscous lidocaine 90 mL, Maalox suspension 90 mL, distilled water 180 mL
– Swish 5 mL for 2 min and expectorate 3–4 times/d. • Option 2
– Dexamethasone 100 mg, viscous lidocaine 60 mL, diphenhydramine 200 mg, sorbitol 15 mL, Maalox suspension to 275 mL
– Swish 5 mL for 2 min and expectorate 3–4 times/d. • Systemic therapy

• Prednisone 5 mg tablets #80 – Take each morning with breakfast for 16 d as 8/d × 4 d,

6/d × 4 d, 4/d × 4 d, 2/d × 4 d, stop – Will reduce disease activity as topical corticosteroids or

systemic NSAIDs are started • Acyclovir 200 mg tablets #42 (if triggered by herpes simplex

virus infection); 1 tablet every 4 h for 7 d or 1 tablet bid-tid as prophylaxis

Exfoliative Cheilitis • Identify possible topical or drug-related causative agents

(eg, gold, toothpaste, mouthwash, lipstick). • Determine if factitial cause(s) is present. • Topical therapy: see “Candidiasis” • Systemic therapy: see “Candidiasis”

Fissured Tongue • Brush tongue surface 10–15 times with dentifrice after meals

and at bedtime to remove debris that causes halitosis. Geographic Tongue

• Brush tongue surface 10–15 times with dentifrice after meals and at bedtime to remove debris that causes halitosis.

• Topical therapy • Fluocinonide gel/cream 0.05% 60 g; apply after meals and at
bedtime • Clotrimazole troches (Mycelex) 10 mg; dissolve 1 troche in
mouth 5 times/d • Clotrimazole vaginal tablets
/2 of 500 mg tablet dissolved in mouth bid
1
• Tacrolimus (Protopic) ointment 0.1% 60 g; apply after meals and at bedtime