{"text":"THE ALAN LYELL CENTRE FOR DERMATOLOGY \nStobhill Hospital \n133 Balornock Road \nGlasgow G21 3UW \\ \nSecretaries: 0141 201 3141 \n- Outpatient Appointments: 0141 201 3459\/3378 \n. Fax: : 01412013144 \n\\ Management Office - Queens Park House, Victoria Infirmary, \n. - &: 0141 201 5807, Fax: 0141 201 5825 \nSouth - Professor Colin Munro, Dr David Bilslaod, Dr Angela Drummond, Dr Felicity Campbell \nWest - Dr Robert Herd, Dr David Tillman, Dr David Burden, Dr Paula Beattie, Dr Joyce Leman \nNorth East - 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 ' <oy \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: Erythema multiforme \u2018 \nManagement: Open appointment \nI reviewed Mrs Clelland. Iexplained that the biopsy has confirmed the clinical impression of \nerythema multiform. Currently it is inactive. In Mirs 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. Other agents \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 oiations with Mrs Clelland on balance we have agreed to simply \nobserve the situation and if she has a significant flare I have asked her to telephone me when [ \nmay need to consider a short course of oral steroids. \nYours sincerely \nHEATHER GRAHAM \nAssociate 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