Journal
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
Volume 64, Issue 4, Pages 619-636Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2010.03.046
Keywords
acrodermatitis chronica atrophicans; Borrelia burgdorferi; erythema migrans; Ixodes scapularis; Lyme borreliosis; Lyme disease; lymphocytoma cutis; neuroborreliosis; ticks; vector-borne disease
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Lyme disease (LD) is an increasingly recognized multisystem, insect-borne zoonosis. Prevalent worldwide, it has a variety of presentations at different stages of infection. The characteristic rash with central clearing known as erythema chronicum migrans, or simply erythema migrans, appears in its first stage. Typical features may be absent, and important variations are evident among cases seen in different parts of the world. LD may be difficult to diagnose clinically; knowledge about its epidemiology and transmission may be of assistance when the diagnosis is unclear. Based upon our experience with LD and a comprehensive literature review, we provide an update of LD epidemiology, pathophysiology, and management. We also cover the three clinical stages of LD that parallel those of syphilis, another spirochetal disease. (J Am Acad Dermatol 2011;64:619-36.)
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