[Erythema migrans with multiple lesions].
BACKGROUND
Erythema migrans with multiple lesions is observed in Europe in only 5-20 p. 100 of Borrelia infections. The number of lesions observed simultaneously in one patient is less than 7, considering all the cases published in the literature to date.


METHODS
We report three patients who presented multiple macular, erythematous and centrifugal lesions localized on the trunk and the limbs. The first patient presented about thirty lesions, the second more than seventy, and the third about twenty. Serology investigation and immunoblots allowed to establish the diagnosis of a recent Borrelia Burgdorferi infection, with multiples lesions of erythema migrans. PCR performed on a skin biopsy of one of the patients confirmed the presence of Borrelia burgdorferi. Response to antibiotic therapy was immediate in all 3 patients.


CONCLUSIONS
These 3 cases are of particular interest because the number of simultaneous lesions is much higher than what is reported in the European literature. These observations remind the clinician that the diagnosis of erythema migrans with multiple lesions should be included, in Europe as well, in the differential diagnosis of multiple annular dermatoses.
Constantin
C
C
Service de Dermatologie et Vénéréologie, Centre Hospitalier Universitaire Vaudois (CHUV/DHURDV), CH-1011 Lausanne, Suisse.
Peter
O
O
Cerottini
J
J
Derighetti
M
M
Panizzon
R
R
Guggisberg
D
D
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D015748:Borrelia burgdorferi Group / Q000145:classification; D004318:Doxycycline / Q000627:therapeutic use; D015787:Erythema Chronicum Migrans / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D015151:Immunoblotting; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000382:microbiology / Q000473:pathology
D000900:Anti-Bacterial Agents; D004318:Doxycycline
Erythème chronique migrant avec lésions multiples.