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Isolation of Borrelia afzelii from circumscribed scleroderma
F H Breier1, E Aberer, G Stanek
1Department of Dermatology, Lainz Municipal Hospital, Wolkersbergenstr. 1, A-1130 Vienna, Austria.
The British Journal of Dermatology
|June 3, 1999
Summary
Circumscribed scleroderma (CS) in a patient was linked to Borrelia afzelii infection. Antibiotic treatment with ceftriaxone successfully resolved the skin lesions and eradicated the spirochaetes.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Circumscribed scleroderma (CS) is a connective tissue disease with potential infectious triggers.
- The role of bacterial infections, particularly spirochaetes, in CS pathogenesis remains under investigation.
Observation:
- A 45-year-old male presented with active CS lesions on his extremities.
- Skin biopsies revealed typical scleroderma histology with lymphocytic and plasmacytic infiltrates.
- Spirochaetes were detected in one biopsy and isolated from active lesions.
Findings:
- The isolated spirochaetes were identified as Borrelia afzelii using SDS-PAGE and PCR.
- Initial penicillin treatment was ineffective, with continued CS progression and positive cultures.
- Two courses of ceftriaxone led to lesion stabilization, reduced sclerosis, and negative cultures/PCR for Borrelia afzelii DNA.
Implications:
- This case suggests Borrelia afzelii may play a pathogenetic role in the development of circumscribed scleroderma.
- Effective treatment of Borrelia afzelii infection with ceftriaxone indicates a potential therapeutic strategy for related scleroderma cases.
- Further research is warranted to elucidate the specific mechanisms by which Borrelia afzelii contributes to CS.