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Lyme Disease (Lyme Borreliosis): click here
Erythema
chronicum migrans is a skin lesion of the tick borne spirochetosis,
Lyme disease.
The annular
lesion,(measures 5-20cm in diameter) develops within 3 months of the
tick bite.
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Lesions are
multiple in some cases. Secondary erythema migrns result from
hematogenous spread of the organism.
The organism
disappear from the lesion after treatment with antibiotics (doxycycline
and synthetic penicillin).
Microscopic
features:
Histologically, there is a superficial and deep perivascular and
interstitial infiltrate of lymphocytes. In some cases plasma cells and
eosinophils are present. Eosinophils may be present at the site of
tick bite. A few neutrophils may also be noted.
Special stain
: Warthin-Starry silver stain - In some specimens spirochetes
are identified in the papillary dermis at the dermoepidermal junction.
Diagnosis may
be confirmed by using an indirect immunofluorescence or
immunoperoxidase techniques.
B. burgdorferi
may also be identified in formalin-fixed paraffin-embedded lesions by
polymerase chain reaction method.
Visit:
Acrodermatitis chronica atrophicans.
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