Cutaneous borreliosis in children - a challenging problem

Area of Science:

• Medical Entomology
• Infectious Diseases
• Dermatology

Background:

• Borreliosis, or Lyme disease, is a significant vector-borne illness caused by Borrelia burgdorferi complex species, prevalent in Europe and North America.
• Ixodoid ticks are the primary vectors, with paediatric cases frequently observed in children aged five to nine.
• European Lyme disease presentation differs from North America, with erythema migrans being the primary early symptom.

Approach:

• This review concentrates on European borreliosis, particularly cutaneous manifestations.
• It examines B. afzelii as a key causative agent in European cutaneous Lyme disease.
• The review synthesizes information on clinical symptoms, diagnostic challenges, and treatment.

Key Points:

• Common European cutaneous symptoms include erythema migrans, lymphocytoma, chronic atrophic dermatitis, and juxta-articular nodules.
• In children, lymphocytoma is a frequent finding, while chronic atrophic dermatitis is rare.
• Non-specific signs post-haematogenic spread pose diagnostic difficulties.

Conclusions:

• Understanding the specific clinical presentations of borreliosis in European children is crucial for accurate diagnosis and management.
• Early recognition of erythema migrans and awareness of lymphocytoma prevalence in children are important.
• Addressing diagnostic challenges, especially with non-specific symptoms, is vital for effective treatment of Lyme disease.