to the editor: I read with great interest the article1 on jaundice in the adult patient in the January 15, 2004, issue of American Family Physician. It was a very informative and useful article. However, I noticed the authors used the term “scleral icterus.” This is a term that is commonly used in textbooks; however, from a histopathologic perspective, it is a misnomer. Bilirubin has a high affinity for elastin which is an abundant protein in the conjunctivae as well as the superficial, fibrovascular episclerae, but not the sclerae proper.2 A more accurate description would therefore be conjunctival icterus.
Letters to the Editor
Use of the Term Conjunctival Icterus Instead of Scleral Icterus
BERT BEISEL, M.D.,
Columbia Family Clinic, 502 Broad St., Columbia, MS 39429
American Family Physician. 2005;71(1):49.
Email letter submissions to afplet@aafp.org. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors. Letters submitted for publication in AFP must not be submitted to any other publication. Letters may be edited to meet style and space requirements.
This series is coordinated by Kenny Lin, MD, MPH, deputy editor.
