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THROUGH THE LENS
Year : 2014  |  Volume : 5  |  Issue : 6  |  Page : 138-139  

Herpes iris of Bateman


Department of Dermatology, Katihar Medical College and Hospital, Karim Bagh, Katihar, Bihar, India

Date of Web Publication5-Dec-2014

Correspondence Address:
Dr. Piyush Kumar
Department of Dermatology, Katihar Medical College and Hospital, Karim Bagh, Katihar - 854 105, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.146199

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How to cite this article:
Kumar P, Anand V, Hassan S. Herpes iris of Bateman. Indian Dermatol Online J 2014;5, Suppl S2:138-9

How to cite this URL:
Kumar P, Anand V, Hassan S. Herpes iris of Bateman. Indian Dermatol Online J [serial online] 2014 [cited 2019 Dec 14];5, Suppl S2:138-9. Available from: http://www.idoj.in/text.asp?2014/5/6/138/146199

An 11-year-old boy presented with mildly painful erythematous rash and vesiculobullous lesions over the trunk and in the oral cavity of three days duration. One day prior, he started developing vesiculobullous lesions over his arms. Ten days prior, he had an episode of sore throat and mild fever, for which he received azithromycin. There was no history of similar lesions in the past or family history of similar lesions. On examination, 'target' lesions were noted over the trunk, oral cavity and genitalia [Figure 1]a. The arms were notable for a distinctive type of lesion, characterized by central bulla over an erythematous background and a ring of vesicles at the margin [Figure 1]b. Systemic examination did not reveal any abnormality. Routine blood examination revealed mild leukocytosis and elevated ESR. Based on classical target lesions and mucosal involvement, clinical diagnosis of erythema multiforme major (EMM) was made. Our case was notable for 'Herpes iris of Bateman' lesions over the upper extremities. The boy was treated conservatively and all lesions subsided within 2 weeks with mild hyperpigmentation.
Figure 1:

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"Herpes Iris of Bateman" is a distinctive skin lesion noted in certain patients of erythema multiforme major that is characterized by a central bulla over an erythematous background and a ring of vesicles at the margin. [1] Such lesions have a predominantly acral distribution and are frequently associated with mucous membrane involvement. [2] These lesions have been described more commonly in Mycoplasma pneumoniae -related cases of erythema multiforme major. [1] Mycoplasma pneumoniae is a relatively common cause of community-acquired bacterial pharyngitis. Though bacteriological confirmation was not done, we suspect sore throat in our case might have been caused by Mycoplasma pneumoniae that was responsible for subsequent EMM with herpes iris of Bateman lesions. Vesicles and/or bulla at the edge of annular or polycyclic lesions are found in chronic bullous disease of childhood (CBDC)/Linear IgA Dermatosis also and is called "string of beads" sign. [3] However, CBDC is a chronic condition, with recurrent vesiculobullous lesions. On the other hand, EMM is a self-limiting condition. [1],[3]

 
   References Top

1.
Roujeau JC. Erythema multiforme. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Fitzpatrick's dermatology in general medicine. 7 th ed. New York: McGraw-Hill; 2008. p. 343-9.  Back to cited text no. 1
    
2.
Haldar B, Ghosh S, Haldar S. Cutaneous vascular responses. In: Valia RG, Valia AR. IADVL Textbook of Dermatology. 3 rd ed. Mumbai, India: Bhalani Publishing House; 2008. p. 656.  Back to cited text no. 2
    
3.
Rao CL, Hall III RP. Linear Immunoglobulin A dermatosis and chronic bullous disease of childhood. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Fitzpatrick's dermatology in general medicine. 7 th ed. New York: McGraw-Hill; 2008. p. 485-90.  Back to cited text no. 3
    


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