[The variable spectrum of cutaneous Lyme borreliosis. Diagnosis and therapy].

Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
H Hofmann

Abstract

Lyme borreliosis can affect almost all human organs. Erythema migrans is the first and most frequent manifestation in 80-90% of patients in the early stage of localized skin infection. Besides the typical clinical appearance, many atypical variants can be observed. The solitary borrelial lymphocytoma is much less common and occurs mostly in children. Due to improvement in the early recognition of Lyme borreliosis, the diagnosis is made in the disseminated and late stage in only 10-20% of patients. Multiple erythemata migrantia indicating the hematogenous dissemination of B. burgdorferi remain frequently unrecognized. Late stages of infection feature chronic plasma-cell rich cutaneous inflammation and acrodermatitis chronica atrophicans in its edematous to atrophic forms. Cultivation or DNA detection of B. burgdorferi in skin biopsies are options to prove unusual skin manifestations. Serological detection of Borrelia-specific IgG- and IgM antibodies should be performed according to the two step protocol with ELISA and immunoassay according to the criteria of the MIQ 12. Serological tests have limited utility for follow-up. Antibiotic therapy is very effective if performed according to evidence-based protocols, such as the AWMF g...Continue Reading

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Citations

Apr 5, 2014·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·S A BraunJ Reifenberger
Feb 28, 2014·TheScientificWorldJournal·Lyuben ZagorchevMariela Odjakova
Sep 13, 2013·Der Internist·L UngerS Schellong
Aug 22, 2012·Ticks and Tick-borne Diseases·Anna MoniuszkoJoanna Zajkowska
Apr 17, 2016·MMW Fortschritte der Medizin·Diana WittmannThomas Ruzicka
Jun 29, 2017·MMW Fortschritte der Medizin·Heidelore Hofmann
Jun 6, 2018·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·A Böer-Auer, R Fölster-Holst

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