Amplification of DNA of Borrelia burgdorferi in Urine Samples of Patients With Granuloma Annulare and Lichen Sclerosus et Atrophicus

Methodological Aspects

“…Wienecke et al (185) could not amplify specific DNA from formalin-fixed, paraffin-embedded skin biopsy specimens. However, in another study (4), the excretion of B. burgdorferi DNA in urine could be demonstrated. With two independent nested PCRs specific for the chromosomal flagellin and the Ly gene, urine samples from 8 of 13 patients with granuloma anulare gave positive results.…”

“…Correlation of PCR results with clinical improvement could also be shown in patients with late disease, e.g., patients with neuroborreliosis (59,75,84,88,93); patients with ACA, morphea, and lichen sclerosus et atrophicus (1,4,114,155,179); patients with LA (19,22,52,78,123); and a patient with osteomyelitis (126).…”

Granulomatous Cheilitis and Borrelia burgdorferi

“…12 Recently, B burgdorferispecific DNA has been found in urine samples from 5 (38%) of 13 patients with granuloma annulare by polymerase chain reaction (PCR). 13 sponse to B burgdorferi has been recognized in patients with sarcoidosis in significantly higher percentages than the respective seroprevalence rate, 12,14 a finding that could not be confirmed by other authors. 15 In the present study, molecular and serologic examinations were performed in 12 patients with GC/ MRS to investigate a possible association with B burgdorferi infection.…”

Critical Evaluation of Urine-Based PCR Assay for Diagnosis of Lyme Borreliosis

“…Even when comparing only reports on urine of patients with erythema migrans (EM) who clearly have an active infection, detection of Borrelia DNA in urine ranged between 13% and Ͼ90% (1,5,20,25,28,30). A caution was issued by Brettschneider et al, who were not able to confirm the presence of Borrelia DNA in the 27% PCR-positive urine specimens by hybridization or sequencing (7).…”

“…A comparison between the different reports is nearly impossible because of significant differences in patient selection, study design, and DNA extraction and PCR methods. Nevertheless, a meta-analysis of urine PCR assays for diagnosis of LB showed an overall sensitivity of 68% (range, 13 to 100%) and a specificity of 99% (range, 95 to 100%) (11).Even when comparing only reports on urine of patients with erythema migrans (EM) who clearly have an active infection, detection of Borrelia DNA in urine ranged between 13% and Ͼ90% (1,5,20,25,28,30). A caution was issued by Brettschneider et al, who were not able to confirm the presence of Borrelia DNA in the 27% PCR-positive urine speci-…”