[Borrelial erythema of the face].
BACKGROUND
Borrelial infection is characterized by various skin manifestations that are usually classified into three main types: chronic migratory erythema, borrelial lymphocytoma and acrodermatitis chronica atrophicans. We report an unusual case of borrelial cutaneous infection presenting as a mediofacial erythema that cannot be included in any of these three categories.


METHODS
A 51-year-old woman presented with infiltrated erythema of the middle of the face extending to the neck and chin. Medical history and physical examination revealed no signs of rosaceae. Infection with Borrelia was suspected on skin biopsy examination, which showed an inflammatory dermal infiltrate containing numerous plasma cells. The diagnosis of B.afzelii infection was confirmed by serology and polymerase chain reaction on the skin biopsy, both of which were positive for B.afzelii.


CONCLUSIONS
Borrelial erythema of the face may represent a special form of cutaneous borrelial infection, which must be considered in the differential diagnosis of facial erythema, especially in areas of endemic borreliosis.
de Heller-Milev
M
M
Service de dermatologie et vénérologie, centre hospitalier universitaire Vaudois (CHUV), Lausanne, Suisse.
Peter
O
O
Panizzon
R-G
RG
Laffitte
E
E
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001706:Biopsy; D015748:Borrelia burgdorferi Group / Q000235:genetics / Q000276:immunology; D003937:Diagnosis, Differential; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D015787:Erythema Chronicum Migrans / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D005148:Facial Dermatoses / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015151:Immunoblotting; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012867:Skin / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004318:Doxycycline