Diagnosis of Lyme disease based on dermatologic manifestations
Malane, M.S.; Grant-Kels, J.M.; Feder, H.M.; Luger, S.W.
Annals of Internal Medicine 114(6): 490-498
1991
ISSN/ISBN: 0003-4819 PMID: 1994797 Document Number: 385031
Diagnosis of Lyme disease, caused by Borrelia burgdorferi, is based primarily on clinical manifestations, the most specific being dermatological. During early infection, secondary erythema migrans lesions or Borrelia lymphocytomata may occur. During late infection, acrodermatitis chronica atrophicans (ACA) may appear, and has been described in 10% of patients with Lyme disease in Europe. Fibrotic nodules associated with ACA, as well as other sclerotic and atrophic lesions such as morphea, lichen sclerosus et atrophicus, anetoderma, and atrophoderma of Pasini and Pierini, have been seen late in the course of Lyme disease. Occasionally sclerodermatous lesions such as eosinophilic fasciitis and progressive facial hemiatrophy have been linked to B. burgdorferi infection. This paper is a review of the various dermatological manifestations of Lyme disease.