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Multiple erythema migrans--manifestation of systemic cutaneous borreliosis

Friederike Egberts1, Maike Möller, Erhardt Proksch

  • 1Department of Dermatology, Venereology and Allergy, University of Schleswig-Holstein, Campus Kiel, Germany. fegberts@dermatology.uni-kiel.de

Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
|January 19, 2008
PubMed

Insights

Multifocal erythema migrans, a rare presentation of early Lyme disease in Europe, can be missed due to atypical appearance. Prompt diagnosis and treatment are crucial for managing this systemic infection.

Area of Science:

  • Infectious Diseases
  • Dermatology
  • Microbiology

Background:

  • Erythema migrans is the characteristic skin lesion of early Lyme disease caused by Borrelia burgdorferi.
  • While common in North America, multifocal erythema migrans lesions are infrequently reported in Europe.

Observation:

  • This report details three cases in Europe presenting with multifocal erythema migrans.
  • The lesions lacked the typical pronounced advancing margin, complicating diagnosis.
  • These atypical presentations posed significant differential diagnostic challenges for clinicians.

Findings:

  • Multifocal erythema migrans signifies an early, systemic stage of Borrelia burgdorferi infection.
  • The absence of classic lesion morphology can lead to delayed or missed diagnoses.

Implications:

  • Early identification of these multifocal lesions is critical for timely intervention.
  • Prompt initiation of antibiotic therapy is essential to manage systemic Lyme disease effectively.
  • Increased awareness of atypical erythema migrans presentations in Europe is warranted.

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