{"text":"THEALAN LYELL CENTRE FOR DERMATO LOGY' \nStobhill Hospital \n133 Balornock Road \nGlasgow G21 3UW \nSecretaries: | 0141201 3141 \n\" Outpatient Appointments: 0141 201 34593378 \nFax: 0141201 3144 \nManagement Office - QueensParkHouse, Victoria Infimary, \n- \u00ae: 0141201 5807, Fax: 0141 201 5825 \nSouth = Professor Colin Munro, Dr David Bilsland, Dr Angela Drummond, Dr Felicity Cimphell \nWest - Dr Robert Herd, D David Tillman, Dr David Burden, Dr Paula Beattie, Dr Joy ce Leman \nNorth Eag - Dr Susan Holmes, Dr Colin Clark, Dr Catherine Jury \n- Dr Lisa Naysmith, Dr Heather Graham \nCLINIC: . 06\/01\/2009 \nDICT: 06\/01\/2009 \nTYPED: 09\/01\/2009 \nHG\/IMcl \nDR GRAHAM'S CLINIC \nDr Marjory Stephens \nKilsyth Health Centre \nBurngreen Park, Kilsyth, Stirlingshire \nG65 OHU \nDear Dr Stephens \nAgnes Clelland - 08\/09\/1955 - CHI: 0809555328 - CRN: 10338654X \n39 Rennie Road, Kilsyth, Glasgow, G65 9PQ \nDiagnosis: Erythe ma.multiforme \nManage ment: - Open appointment \nI reviewed Mrs Clelland. I explained that the biopsy has confirmed the clinical impression of \nerythema multiform. Currently it is inactive. In Mrs Clelland's case it always seems to be \nassociated with infections, although unfortunately it is either a cold sore, a dental infection or \nurinary infection. If it was simply a cold sore we could consider long-term Acyclovir therapy but \nI do not think it is appropriate when other infections are also causing the triggers. Otheragents \nused are either immune-suppression tablets, but she already has hypertension and is diabetic, or \nThalidomide is used but she already has neuropathy secondary to her diabetes. \nI have discussed all of these options with Mrs Clelland on balance we have\u2018agreed to simply \nobserve the situation and if she has.a significant flare I have asked her t6 telephone me when I \nmay need to consider a short course of oral steroids. \nYours sincerely \nHEATHER GRAHAM \nAssociate 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