Parry-Romberg syndrome: a possible association with borreliosis

Progressive facial hemiatrophy or Parry-Romberg syndrome is a rare entity characterized by unilateral atrophy of the skin, subcutaneous tissue and the underlying bony structures. This syndrome has many features of linear scleroderma 'en coup de sabre' but is distinguished by more extensive involvement of the lower face with only slight cutaneous sclerosis. The onset typically occurs in childhood or young adult years. The aetiology of the condition is unknown. A case of progressive hemifacial atrophy occurring in a 30-year-old woman is reported, in which the aetiology is thought to be Lyme disease, a borrelial infection first recognized in 1975 that has since become the most commonly reported vector-borne disease in the world. No sure link is established between these two disease states, but their coincident occurrence in this patient is noted. We hypothesize that the aetiology of Parry-Romberg syndrome involves borreliosis.