Spirochetes in Lesions of Erythema Chronicum Migrans

Bw, Berger; Oj, Clemmensen; Gj, Gottlieb

doi:10.1097/00000372-198212000-00013

Cited by 27 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Borrelia spirochete (Borrelia burg dorferi) was identified in skin biopsy speci mens from patients with ECM in USA and in Europe [4,[6][7].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Erythema chronicum migrans: Evidence for Cellular Immune Reaction in the Skin Lesion

Büchner¹,

Rufli²

1987

Dermatology

View full text Add to dashboard Cite

Skin biopsy specimens from 9 patients with erythema chronicum migrans (ECM) were studied immunohistochemically using a series of monoclonal antibodies. In biopsy specimens taken from the erythematous peripheral portion of ECM the perivascular infiltrates were composed predominantly of LEU-4+ T cells. LEU-3a + helper/inducer T cells were more numerous than LEU-2a+ cytotoxic/suppressor T cells. Of particular interest was the high number of LEU-6+ Langerhans cells in the epidermis and dermis of specimens taken from the erythematous portion of ECM as well as from the noninflammatory skin outside the erythema. The presence of LEU-6 + Langerhans cells and T cells in the ECM lesions suggests that, apart from humoral factors, a cell-mediated immune response directed against Borrelia burgdorferi antigen is important as well in the pathogenesis of this disease.

show abstract

“…The Borrelia spirochete (Borrelia burg dorferi) was identified in skin biopsy speci mens from patients with ECM in USA and in Europe [4,[6][7].…”

mentioning

confidence: 99%

“…Histologically ECM lesions are charac terized by superficial or deep perivascular infiltrate composed mostly of lymphocytes, histiocytes and plasma cells [7,12,13].…”

mentioning

confidence: 99%

Erythema chronicum migrans: Evidence for Cellular Immune Reaction in the Skin Lesion

Büchner¹,

Rufli²

1987

Dermatology

View full text Add to dashboard Cite

show abstract

“…5 In addition to multiple lesions, other atypical presentations include the absence of a targetoid appearance and uniform erythema, with no central clearing. 2,8,[10][11][12][13][16][17][18][19] The presence of plasma cells scattered throughout the dermis increases the specificity that the infiltrate may represent erythema migrans. 2,8,[10][11][12][13][16][17][18][19] The presence of plasma cells scattered throughout the dermis increases the specificity that the infiltrate may represent erythema migrans.…”

Section: Discussionmentioning

confidence: 99%

“…Cases 1 and 3 demonstrated both an increase in eosinophils, at the periphery of the expanding lesion of erythema migrans as opposed to the center of the lesion, and a vacuolar change along the dermoepidermal junction. 2,8,[10][11][12][16][17][18][19] Likewise, spirochetes were not seen on silver-stained sections in all 4 specimens. This finding is not novel and has been described previously by De Koning, 11 who noted that "sometimes a lymphocytic infiltrate is located at the dermoepidermal junction with disruption of the basement membrane" in erythema migrans, and Böer et al, 23 The presence of interstitial neutrophils in case 4 was suggestive of an urticarial eruption.…”

Section: Discussionmentioning

confidence: 99%

Erythema Migrans

Wilson

Legler²,

Madison³

et al. 2012

The American Journal of Dermatopathology

View full text Add to dashboard Cite

Early cutaneous Lyme disease, erythema migrans, manifests as a gyrate erythema at the site of a tick bite. The standard histopathologic description is that of a superficial and deep perivascular lymphocytic infiltrate in which plasma cells are identified at the periphery of the lesion and eosinophils in the center. Deviation from these commonly accepted histopathologic findings may lead to an erroneous diagnosis. Herein, we describe 4 cases of erythema migrans, all biopsied at the periphery of the lesion and confirmed by serologic studies, demonstrating a variety of unconventional histopathologic patterns. These findings include eosinophils and neutrophils at the periphery of the expanding annular plaque of erythema migrans, focal interface change, spongiosis, involvement of the superficial vascular plexus alone, and an absence of plasma cells in all cases. These cases highlight the varied and nonspecific histopathologic changes that can be seen in erythema migrans, including the absence of plasma cells and the presence of focal interface change. Based on these findings, the dermatopathologist should always consider erythema migrans as a diagnostic possibility in a biopsy specimen from an expanding gyrate or annular erythema despite the presence of unusual features. In atypical clinical cases, serologic confirmation may be required for diagnosis in the presence of histopathologic findings considered unconventional for erythema migrans.

show abstract

“…The classification of these diseases is based essentially on the morpho logical aspects, the course of the disease and the etiological factors. Nowadays some authors [2,3] differentiate these forms of erythema clinically: erythema chronicum migrans (ECM), caused by a tick vector [4,5]; erythema gyratum repens (EGR) de veloping in patients with internal malignan cies [2,3,6]; erythema marginatum rheumaticum (EMR), linked to rheumatic fever [7].…”

Section: Introductionmentioning

confidence: 99%

Gyrate Erythema in a Patient with Dental Radicular Cyst

Monti¹,

Cavicchini²,

Bitonto³

et al. 1987

Dermatology

View full text Add to dashboard Cite

Nonspecific gyrate erythemas (NGE) are commonly associated with hypersensitivity reactions to exogenous or endogenous antigens. A case of NGE with clinical resemblance to tinea corporis in a patient with a dental radicular cyst is reported. Cutaneous lesions disappeared after surgical excision of the dental cyst. The clinical and pathological details are described and the relationship between radicular cyst and cutaneous lesions discussed. Earlier reports are reviewed and the possibility of a focal origin is emphasized.

show abstract

Spirochetes in Lesions of Erythema Chronicum Migrans

Cited by 27 publications

References 0 publications

Erythema chronicum migrans: Evidence for Cellular Immune Reaction in the Skin Lesion

Erythema chronicum migrans: Evidence for Cellular Immune Reaction in the Skin Lesion

Erythema Migrans

Gyrate Erythema in a Patient with Dental Radicular Cyst

Contact Info

Product

Resources

About