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JAMA Ophthalmology Clinical Challenge
October 2016

Eruption of Eyelid Target Lesions

Author Affiliations
  • 1Birmingham and Midland Eye Centre, Birmingham, England
JAMA Ophthalmol. 2016;134(10):1189-1190. doi:10.1001/jamaophthalmol.2016.0934

A teenaged boy awakened 2 days prior to presentation with a few skin lesions, which rapidly spread to the rest of his right eyelids (Figure 1). The rash caused a burning sensation; otherwise, he was feeling well. He was not taking any regular medication. His visual acuity was 20/20 OU. Examination revealed clusters of target lesions on the right upper and lower eyelids. There were papillae in the upper palpebral conjunctiva and follicles and a few pustules in the lower palpebral conjunctiva. The cornea was unremarkable with no staining, and results of a dilated ophthalmoscopy examination were normal. Ocular movements were full, and there was no proptosis. A few solitary lesions were found scattered on his nose and right cheek; however, his body was not affected. He had a tender right submandibular lymphadenopathy but was apyrexial.

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