Herpes iris of Bateman.

Abstract

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 1a]. 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 1b]. 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.