title: Erythema migrans.
abstract: Erythema migrans (EM) is the most common objective manifestation of Borrelia burgdorferi infection. Systemic symptoms are usually present. Most patients do not recall a preceding tick bite. Despite a characteristic appearance, EM is not pathognomonic for Lyme disease and must be distinguished from other similar appearing skin lesions. EM is a clinical diagnosis; serologic and PCR assays are unnecessary. Leukopenia and thrombocytopenia are indicative of either an alternative diagnosis, or coinfection with another tick-borne pathogen. When EM is promptly treated with appropriate antimicrobial agents, the prognosis is excellent. Persons in endemic areas should take measures to prevent tick bites.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, New York Medical College, Skyline Office #2NC20, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA. Electronic address: robert_nadelman@nymc.edu.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Nadelman
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D015787:Erythema Chronicum Migrans / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis; D016133:Polymerase Chain Reaction; D011379:Prognosis
chemical_list: D000900:Anti-Bacterial Agents
keywords: Borrelia burgdorferi; Erythema migrans; Lyme disease