title: Clinical spectrum of skin manifestations of Lyme borreliosis in 204 children in Austria.
abstract: The spectrum of skin manifestations of Lyme borreliosis in children is not well characterized. We conducted a retrospective study to analyze the clinical characteristics, seroreactivity to Borrelia burgdorferi sensu lato, and outcome after treatment in 204 children with skin manifestations of Lyme borreliosis seen in 1996-2011. Solitary erythema migrans was the most common manifestation (44.6%), followed by erythema migrans with multiple lesions (27%), borrelial lymphocytoma (21.6%), and acrodermatitis chronica atrophicans (0.9%). A collision lesion of a primary borrelial lymphocytoma and a surrounding secondary erythema migrans was diagnosed in 5.9% of children. Rate of seroreactivity to B. burgdorferi s.l. was lower in solitary erythema migrans compared to other diagnosis groups. Amoxicillin or phenoxymethylpenicillin led to complete resolution of erythema migrans within a median of 6 (solitary) and 14 days (multiple lesions), respectively, and of borrelia lymphocytoma within a median of 56 days. In conclusion, erythema migrans with multiple lesions and borrelial lymphocytoma appear to be more frequent in children than in adults, whereas acrodermatitis chronica atrophicans is a rarity in childhood. The outcome after antibiotic therapy was excellent in children, and appears to be better than in adults.
authors.affiliation: Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036 Graz, Switzerland. glatz.martin@gmx.net.
authors.forename: Martin
authors.initials: M
authors.lastname: Glatz
authors.forename: Astrid
authors.initials: A
authors.lastname: Resinger
authors.forename: Kristina
authors.initials: K
authors.lastname: Semmelweis
authors.forename: Christina M
authors.initials: CM
authors.lastname: Ambros-Rudolph
authors.forename: Robert R
authors.initials: RR
authors.lastname: Müllegger
mesh_terms: D000169:Acrodermatitis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D000284:Administration, Oral; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D025065:Borrelia burgdorferi / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D015787:Erythema Chronicum Migrans / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008193:Lyme Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D019310:Pseudolymphoma / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents