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| Fig. 27.9 Typical lesion of erythema chronicum migrans manifesting as central papule at the tick bite site surrounded by annular erythema. |
Lyme disease is a multisystem disease caused by
Borrelia burgdorferi that is transmitted to humans by ticks of the genus
Ixodes. One to 30 days after the tick bite, patients present with variable constitutional symptoms, including fever, malaise, headache, and arthralgias. Approximately three fourths of patients develop erythema chronicum migrans that begins as an erythematous papule at the bite site and progresses to an annular erythema that may reach 20 cm or more in size (Fig. 27-9).
Müllegger RR, Glatz M: Skin manifestations of Lyme borreliosis: diagnosis and management,
Am J Clin Dermatol 9:355–368, 2008.
