Erythema chronicum migrans of Lyme disease.
Erythema chronicum migrans (ECM) is the distinctive cutaneous lesion of the multisystem tick-borne spirochetosis, Lyme disease. Its clinical and histologic pictures are variable. Of the 51 patients with ECM of Lyme disease, 38 patients (75%) had single lesions, 13 patients (25%) had multiple lesions, and 32 patients (62%) had extracutaneous signs and symptoms. Only 15 patients (29%) had symptoms referable to ECM. Extracutaneous signs and symptoms were absent in 12 (80%) of the 15 patients. These patients had uneventful recoveries following treatment with systemic antibiotics. Thirty-four skin biopsy specimens were obtained from the ECM lesions of 30 patients. With Warthin-Starry silver stain, the Ixodes dammini spirochete was found in 14 specimens (41%) taken from 12 (40%) of the 30 patients. Two of the Ixodes dammini spirochete-positive specimens were obtained from secondary ECM lesions. Careful clinical and histologic examination of skin lesions suggestive of ECM of Lyme disease will expedite its early diagnosis and treatment.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D004890:Erythema / Q000473:pathology*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007223:Infant; D008875:Middle Aged; D012867:Skin / Q000382:microbiology / Q000473:pathology; D013987:Ticks / Q000276:immunology / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M