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Morphea after Borrelia-induced facial nerve palsy

Catherine B Xie1, Shawn Cowper2,3, Ian D Odell2

  • 1Department of Immunobiology, School of Medicine, Yale University, New Haven, CT, USA.

Journal of Scleroderma and Related Disorders
|April 6, 2022
PubMed

Insights

This case suggests Borrelia burgdorferi may trigger morphea by disrupting local immune tolerance, following facial nerve palsy. This finding offers new insights into localized scleroderma pathogenesis.

Area of Science:

  • Immunology
  • Dermatology
  • Infectious Disease

Background:

  • Morphea (localized scleroderma) involves skin inflammation and fibrosis with unknown pathogenesis.
  • Autoimmune predisposition combined with environmental factors are suspected causes.
  • Previous associations with Borrelia infection are not broadly applicable.

Observation:

  • A young man with a family history of autoimmune disease developed facial morphea.
  • This occurred in the same location as two prior episodes of Borrelia-induced facial nerve palsy.
  • Facial nerve palsy is an autoimmune phenomenon common in Borrelia-endemic areas.

Findings:

  • The case suggests Borrelia burgdorferi may induce a loss of local immune tolerance to host antigens.
  • This immune dysregulation manifested first as facial nerve palsy and later as morphea.
  • This represents a potential mechanism linking Borrelia infection to localized scleroderma development.

Implications:

  • This case highlights a potential role for Borrelia burgdorferi in morphea pathogenesis.
  • It suggests a mechanism of infection-induced autoimmunity in localized scleroderma.
  • Further research may explore Borrelia infection as a trigger for autoimmune skin conditions.
Keywords:
Borrelia burgdorferiLocalized sclerodermaParry–Romberg syndromefacial nerve palsylyme diseasemorpheaneuroborreliosis

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