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LETTER TO EDITOR
Year : 2011  |  Volume : 59  |  Issue : 2  |  Page : 167

Reply: Coin-shaped epithelial lesions following an acute attack of erythema multiforme minor with confocal microscopy findings


Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Center, Bangalore, Karnataka, India

Date of Web Publication23-Feb-2011

Correspondence Address:
Kalpana Babu
Prabha Eye Clinic and Research Centre, 504, 40th Cross, Jayanagar 8th Block, Bangalore - 560 070, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.77016

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How to cite this article:
Babu K, Murthy VR, Akki VP, Prabhakaran VC, Murthy K R. Reply: Coin-shaped epithelial lesions following an acute attack of erythema multiforme minor with confocal microscopy findings. Indian J Ophthalmol 2011;59:167

How to cite this URL:
Babu K, Murthy VR, Akki VP, Prabhakaran VC, Murthy K R. Reply: Coin-shaped epithelial lesions following an acute attack of erythema multiforme minor with confocal microscopy findings. Indian J Ophthalmol [serial online] 2011 [cited 2020 Jun 7];59:167. Available from: http://www.ijo.in/text.asp?2011/59/2/167/77016

Dear Editor,

We thank Jain et al. [1] for their interest in our article. [2] We do agree that these lesions do improve with topical steroids. What is important here is the presence of additional systemic features like skin eruptions or involvement of a mucosa. In our patient, there were skin eruptions and painful buccal mucosal ulcers following a viral illness. Herpes simplex virus-induced erythema multiforme (EM) minor constitutes 15-60% of EM minor. The treatment is a combination of acyclovir and oral steroids. [3]

Treatment with oral steroids along with oral acyclovir is definitely justified in our case. In contrast, we do see cases of EM minor with only ocular involvement in the form of coin-shaped lesions which will definitely improve only with topical steroids just like the case described by Jain et al. [1] As we have described the confocal microscopy findings speculating an immunological mechanism in the development of these coin-shaped lesions on the cornea, these lesions will definitely respond to topical steroids.

 
  References Top

1.
Jain S, Rathore MK, Dwivedi PC, Tirkey E. Corneal lesions in erythema multiforme minor - Are systemic steroids indicated? Indian J Ophthalmol. 2010;58(6):559-60.   Back to cited text no. 1
    
2.
Babu K, Murthy VR, Akki VP, Prabhakaran VC, Murthy KR. Coin-shaped epithelial lesions following an acute attack of erythema multiforme minor with confocal microscopy findings. Indian J Ophthalmol 2010;58:64-6.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Farthing P, Bagan JV, Scully C. Mucosal disease series. Number IV. Erythema multiforme. Oral Dis 2005;11:261-7.  Back to cited text no. 3
    



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