Vesicular erythema migrans

Goldberg, N. S.

doi:10.1001/archderm.128.11.1495

Cited by 9 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The combination of ACA, streaking, and blister exudate is fundamentally a combination of three different types of rashes culminated in co-infection of Bbsl and Bartonella sp. Based on the findings of Goldberg et al [ 56 ], the exudate droplets on the right lower leg of Case 5 could be harboring Bbsl spirochetes and/or Bartonella sp. bacteria.…”

Section: Discussionmentioning

confidence: 95%

“…The preliminary ACA manifestations are often clinically overlooked or misdiagnosed, and attributed to circulatory problems or aging [ 27 ]. For example, a blister rash has been frequently mistaken for poison ivy, allergic reactions, and herpes simplex [ 56 ]. In addition, Berger et al demonstrated that punch skin biopsy specimens taken from the peripheral border of EM rashes cultured positive in 18 (86%) of 21 specimens and, notably, two of these EM lesions were less than 5 mm in diameter [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada

Scott

2020

Healthcare

View full text Add to dashboard Cite

Lyme disease (Lyme borreliosis) is a complex multisystem illness with varying clinical manifestations. This tick-borne zoonosis is caused by the spirochetal bacterium, Borrelia burgdorferi sensu lato (Bbsl) and, worldwide, presents with at least 20 different types of rashes. Certain cutaneous rashes are inherently interconnected to various stages of Lyme disease. In this study, five Canadian Lyme disease patients from a multi-age range presented various phases of the acrodermatitis chronica atrophicans (ACA) rash. In each case of ACA, the underlying etiological pathogen was the Lyme disease spirochete. Although ACA rashes are normally found on the lower extremities, this study illustrates that ACA rashes are not directly correlated with a tick bite, geographic area, age, Bbsl genospecies, exercise, or any given surface area of the body. Case 4 provides confirmation for an ACA rash and gestational Lyme disease. One patient (Case 5) puts forth a Bbsl and Bartonella sp. co-infection with a complex ACA rash. This study documents ACA rashes on Lyme disease patients for the first time in Canada.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada

Scott

2020

Healthcare

View full text Add to dashboard Cite

show abstract

“…In prospective studies of U.S. patients with Lyme disease-associated erythema migrans, 3.7% to 8% had central vesicles and/or bullae containing clear, cloudy, or hemorrhagic fluid [8,9,10,11,12]. The observation that the vesicles and bullae occur exclusively in the center of erythema migrans has prompted the hypothesis that they may represent a reaction to the tick bite [11]. This is supported by our patient's histology showing a tick bite reaction with edema and localized lymphocytic vasculitis.…”

Section: Discussionmentioning

confidence: 99%

Vesicular erythema migrans: an atypical and easily misdiagnosed form of Lyme disease

Mazori

Orme

Mir

et al. 2015

Dermatology Online Journal

View full text Add to dashboard Cite

Erythema migrans is the initial sign in the majority of patients infected with Borrelia, the genus of spirochetes that causes Lyme disease. Early identification and treatment decrease the risk of progression to later stages of disease. Although a "bull's eye" appearance owing to lesional clearing is considered classic for erythema migrans, this feature is surprisingly often lacking among patients in the United States. Furthermore, cutaneous Lyme disease can exhibit a wide range of morphologic variability in a minority of patients. Herein, we describe the case of a patient with Lyme disease in which the presence of atypical vesicular features, in conjunction with the initial absence of clearing, resulted in multiple misdiagnoses and delayed treatment. We also review the literature on the epidemiology and management of erythema migrans for cases in which the diagnosis may pose a challenge.

show abstract

“…Also commonly reported are secondary disseminated lesions [16, 19–23], occurring in 8–25% of cases [7, 9, 15, 17]. Less common, but consistently reported manifestations of EM include vesiculopustular lesions [9, 15, 17, 20–22, 24] and lesions that develop a blue-purple bruise-like appearance [15, 18]. …”

Section: Methodsmentioning

confidence: 99%

Bull’s-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans

Aucott

Crowder²,

Yedlin³

et al. 2012

Dermatology Research and Practice

View full text Add to dashboard Cite

Introduction. Lyme disease is an emerging worldwide infectious disease with major foci of endemicity in North America and regions of temperate Eurasia. The erythema migrans rash associated with early infection is found in approximately 80% of patients and can have a range of appearances including the classic target bull's-eye lesion and nontarget appearing lesions. Methods. A survey was designed to assess the ability of the general public to distinguish various appearances of erythema migrans from non-Lyme rashes. Participants were solicited from individuals who visited an educational website about Lyme disease. Results. Of 3,104 people who accessed a rash identification survey, 72.7% of participants correctly identified the classic target erythema migrans commonly associated with Lyme disease. A mean of 20.5% of participants was able to correctly identify the four nonclassic erythema migrans. 24.2% of participants incorrectly identified a tick bite reaction in the skin as erythema migrans. Conclusions. Participants were most familiar with the classic target erythema migrans of Lyme disease but were unlikely to correctly identify the nonclassic erythema migrans. These results identify an opportunity for educational intervention to improve early recognition of Lyme disease and to increase the patient's appropriate use of medical services for early Lyme disease diagnosis.

show abstract

Vesicular erythema migrans

Cited by 9 publications

References 0 publications

Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada

Presentation of Acrodermatitis Chronica Atrophicans Rashes on Lyme Disease Patients in Canada

Vesicular erythema migrans: an atypical and easily misdiagnosed form of Lyme disease

Bull’s-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans

Contact Info

Product

Resources

About