Custom-made trays for targeted treatment of oral vesiculobullous diseases: A proposed protocol

Topical and intralesional corticosteroids (CS) are effective treatments for oral manifestations of autoimmune vesiculobullous diseases (VBD); however, may cause unnecessary absorption in the adjacent healthy mucosal surfaces, local infections, atrophy, and injection pain. To propose a protocol using a unique modality for targeted administration of CS for the treatment of local manifestations of oral VBD. The medical records of nine patients with systemic CS-resistant VBD oral lesions, were reviewed following 3 weeks of treatment and 3 months of tapering using a custom-made tray designed for precise application of topical CS targeted to the involved mucosa. Following treatment, lesions have healed in 8/9 patients. Involvement of surrounding mucosa was minimal, and no systemic adverse effects were recorded. The proposed protocol using custom-made trays for targeted CS treatment could be an effective alternative treatment for oral VBD.