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Histopathology of erythema migrans (ECM), a Lyme disease indicator, shows varied lymphocytic infiltrates and interface changes. Recognizing these diverse features is crucial for accurate diagnosis.

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Area of Science:

  • Dermatopathology
  • Infectious Disease Histology

Background:

  • Erythema migrans (ECM) histology is typically nonspecific perivascular infiltrate.
  • Variations like interface changes can challenge clinicopathological diagnosis.

Purpose of the Study:

  • To delineate the histopathologic features of erythema migrans (ECM).
  • To identify key diagnostic histological markers for ECM.

Main Methods:

  • Retrospective review of 14 ECM cases with confirmed serology or clinical suspicion.
  • Analysis of biopsy findings including inflammatory infiltrate patterns and cellular composition.

Main Results:

  • All biopsies showed superficial perivascular lymphocytic infiltrate.
  • Deep/interstitial infiltrate occurred in 64%, focal interface changes in 86%.
  • Eosinophils and plasma cells were present in 50% and 71% of cases, respectively.

Conclusions:

  • ECM is a histologically protean entity with variable lymphocytic infiltrates and interface dermatitis.
  • Consider ECM in differential diagnoses of focal interface or sparse perivascular dermatitis with appropriate clinical context.