title: The many faces of solitary and multiple erythema migrans.
abstract: Case definitions for European Lyme disease have been published. However, multiple erythema migrans may pose a diagnostic challenge. Therefore, we retrospectively reviewed the clinical and serological findings and response to therapy in a cohort of consecutive 54 patients with PCR-confirmed erythema migrans, referred to a university dermatology clinic. The proportion of patients with multiple erythema migrans lesions (usually 2 or 3) was almost equal (46%) to the proportion of patients with single erythema migrans lesions (54%). All patients, except for 2 multiple erythema migrans patients with a concomitant autoimmune disease, completely responded to treatment. In conclusion, multiple erythema migrans may be more common than anticipated, and since only 50% of the patients were seropositive when seeking medi-cal help, PCR testing of skin lesions is helpful to confirm the diagnosis in clinically atypical cases.
authors: Department of Dermatology and Allergology, Helsinki University Central Hospital, FIN-00029 HUS, Finland. pernilla.eriksson@fimnet.fi.
authors: Pernilla
authors: P
authors: Eriksson
authors: Marika T
authors: MT
authors: Schröder
authors: Kirsi
authors: K
authors: Niiranen
authors: Antti
authors: A
authors: Nevanlinna
authors: Jaana
authors: J
authors: Panelius
authors: Annamari
authors: A
authors: Ranki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D001706:Biopsy; D025065:Borrelia burgdorferi / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000302:isolation & purification; D015787:Erythema Chronicum Migrans / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012698:Serologic Tests; D012867:Skin / Q000187:drug effects / Q000382:microbiology* / Q000473:pathology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D004269:DNA, Bacterial