title: Borrelia in granuloma annulare, morphea and lichen sclerosus: a PCR-based study and review of the literature.
abstract: BACKGROUND
  Morphea, granuloma annulare (GA) and lichen sclerosus et atrophicans (LSA) have also been suggested to be linked to Borrelia infection. Previous studies based on serologic data or detection of Borrelia by immunohistochemistry and polymerase chain reaction (PCR) reported contradictory results. Thus, we examined skin biopsies of morphea, GA and LSA by PCR to assess the prevalence of Borrelia DNA in an endemic area and to compare our results with data in the literature.
  
  
  METHODS
  Amplification of DNA sequences of Borrelia burgdorferi sensu lato by nested PCR from formalin-fixed and paraffin-embedded skin biopsies of morphea, GA and LSA, followed by automated sequencing of amplification products. PCR-based studies on Borrelia species in these disorders published until July 2009 were retrieved by a literature search.
  
  
  RESULTS
  Borrelia DNA was detected in 3 of 112 skin biopsies (2.7%) including one of 49 morphea biopsies (2.0%), one of 48 GA biopsies (2.1%) and one of 15 LSA biopsies (6.6%). Amplification products belonged to B. burgdorferi sensu stricto in two cases available for sequence analysis.
  
  
  CONCLUSIONS
  The results of our and most of other PCR-based studies do not argue for a significant association of B. burgdorferi sensu lato with morphea, GA, LSA.
authors.affiliation: Kempf und Pfaltz Histologische Diagnostik, Zürich, Switzerland.
authors.forename: Therese
authors.initials: T
authors.lastname: Zollinger
authors.forename: Kirsten D
authors.initials: KD
authors.lastname: Mertz
authors.forename: Mirka
authors.initials: M
authors.lastname: Schmid
authors.forename: Anja
authors.initials: A
authors.lastname: Schmitt
authors.forename: Madeleine
authors.initials: M
authors.lastname: Pfaltz
authors.forename: Werner
authors.initials: W
authors.lastname: Kempf
mesh_terms: D001898:Borrelia / Q000235:genetics*; D001899:Borrelia Infections / Q000150:complications / Q000235:genetics / Q000473:pathology*; D016460:Granuloma Annulare / Q000150:complications / Q000235:genetics / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000150:complications / Q000235:genetics / Q000382:microbiology* / Q000473:pathology; D016133:Polymerase Chain Reaction; D012594:Scleroderma, Localized / Q000150:complications / Q000235:genetics / Q000382:microbiology* / Q000473:pathology; D012867:Skin / Q000382:microbiology* / Q000473:pathology