406 results match your criteria Acrodermatitis Chronica Atrophicans
J Cutan Pathol 2018 Apr 9;45(4):274-277. Epub 2018 Feb 9.
Departments of Dermatology and Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Lyme disease classically evolves through clinical manifestations according to the stage of illness. Because many of the systemic symptoms are non-specific, and because serology may yield false negative results, cutaneous findings merit even greater importance to diagnosis. The prototypical skin lesion, erythema migrans (EM), occurs early and is the only independent diagnostic clinical feature according to the guidelines of the Infectious Diseases Society of America. Read More
Am J Dermatopathol 2018 May;40(5):367-370
Department of Dermatology, Medical University of Graz, Graz, Austria.
Acrodermatitis chronica atrophicans (ACA) that is characterized by thin, papery dry, translucent, and alopecic patches with visible superficial veins is a late cutaneous manifestation of Lyme borreliosis. Clinical findings, a history of exposure to tick bite, and serology are helpful for the diagnosis of ACA and sometimes a biopsy is performed to rule out other infectious or inflammatory processes. In this study, we report reflectance confocal microscopy (RCM) findings in a case of ACA. Read More
Ger Med Sci 2017 5;15:Doc14. Epub 2017 Sep 5.
Klinik für Infektiologie Klinik St Georg, Leipzig, Germany.
This guideline of the German Dermatology Society primarily focuses on the diagnosis and treatment of cutaneous manifestations of Lyme borreliosis. It has received consensus from 22 German medical societies and 2 German patient organisations. It is the first part of an AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. Read More
Br J Dermatol 2017 Oct 8;177(4):1127-1130. Epub 2017 Sep 8.
Dermatology Department, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
Acrodermatitis chronica atrophicans (ACA) is the late cutaneous form of Lyme borreliosis. The early inflammatory phase manifests with a bluish-red discoloration and doughy swelling of the skin. The atrophic phase represents a late-phase process with red discoloration, and a thin and wrinkled appearance of the skin. Read More
Hautarzt 2017 Apr;68(4):329-339
Abteilung für Dermatologie, Landesklinikum Wiener Neustadt, Wiener Neustadt, Österreich.
Serology, the detection of B. burgdorferi-specific IgM and IgG serum antibodies, is the most common laboratory test to diagnose cutaneous manifestations of Lyme disease. In a two-tiered approach, an ELISA is used as a screening test. Read More
Infect Genet Evol 2017 04 28;49:48-54. Epub 2016 Dec 28.
Laboratory for Zoonoses and Environmental Microbiology, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Electronic address:
Both early localized and late disseminated forms of Lyme borreliosis are caused by Borrelia burgdorferi senso lato. Differentiating between the spirochetes that only cause localized skin infection from those that cause disseminated infection, and tracing the group of medically-important spirochetes to a specific vertebrate host species, are two critical issues in disease risk assessment and management. Borrelia burgdorferi senso lato isolates from Lyme borreliosis cases with distinct clinical manifestations (erythema migrans, neuroborreliosis, acrodermatitis chronica atrophicans, and Lyme arthritis) and isolates from Ixodes ricinus ticks feeding on rodents, birds and hedgehogs were typed to the genospecies level by sequencing part of the intergenic spacer region. Read More
Ticks Tick Borne Dis 2017 02 24;8(2):266-269. Epub 2016 Nov 24.
Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia. Electronic address:
Background: The pathogenesis of acrodermatitis chronica atrophicans (ACA) is not well understood.
Objective: The purpose of this study was to gain a better understanding of ACA by utilizing a large data set of adult Slovenian patients with Lyme borreliosis.
Methods: The age of 590 ACA patients was compared with that of patients with other manifestations of Lyme borreliosis. Read More
Nat Rev Dis Primers 2016 12 15;2:16090. Epub 2016 Dec 15.
Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.
Lyme borreliosis is a tick-borne disease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the bacterium Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. Read More
Expert Rev Mol Diagn 2017 01 28;17(1):19-30. Epub 2016 Nov 28.
a Institute of Microbiology ansd Immunology, Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia.
Introduction: Current laboratory testing of Lyme borreliosis mostly relies on serological methods with known limitations. Diagnostic modalities enabling direct detection of pathogen at the onset of the clinical signs could overcome some of the limitations. Molecular methods detecting borrelial DNA seem to be the ideal solution, although there are some aspects that need to be considered. Read More
Rheumatology (Oxford) 2016 Nov 6. Epub 2016 Nov 6.
Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
PLoS One 2016 5;11(10):e0164117. Epub 2016 Oct 5.
EA7290 Early Bacterial Virulence: Lyme borreliosis Group, FMTS, Université de Strasbourg, Strasbourg, France.
In Lyme borreliosis, the skin is the key site for bacterial inoculation by the infected tick and for cutaneous manifestations. We previously showed that different strains of Borrelia burgdorferi sensu stricto isolated from tick and from different clinical stages of the Lyme borreliosis (erythema migrans, and acrodermatitis chronica atrophicans) elicited a very similar transcriptional response in normal human dermal fibroblasts. In this study, using whole transcriptome microarray chips, we aimed to compare the transcriptional response of normal human dermal fibroblasts stimulated by 3 Borrelia burgdorferi sensu lato strains belonging to 3 main pathogenic species (B. Read More
Reumatologia 2016 18;54(3):97-102. Epub 2016 Jul 18.
Universidad Autonóma de Nuevo León, School of Biological Sciences, Institute of Biotechnology, Nuevo León, Mexico; Rheumatology Unit, Medical Faculty and University Hospital Dr. José Eleuterio González, Nuevo León, Mexico.
Objectives: Lyme disease is a tick-borne disease caused by infections with Borrelia. Persons infected with Borrelia can be asymptomatic or can develop disseminated disease. Diagnosis and recognition of groups at risk of infection with Borrelia burgdorferi is of great interest to contemporary rheumatology. Read More
Skinmed 2016 1;14(3):217-9. Epub 2016 Jun 1.
Department of Dermatology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ;
A 70-year-old man was referred by his rheumatologist to our dermatology clinic for evaluation of dermatitis on his right arm that appeared 3 months earlier. The skin lesion was asymptomatic and the patient denied current systemic symptoms, including fever, chills, and joint pain; however, 10 months prior to this presentation he experienced arthritis in the left knee. At that time, Borrelia serology revealed positive IgG (6. Read More
BMJ Case Rep 2016 Jun 22;2016. Epub 2016 Jun 22.
Department of Dermatology, Medisch Centrum Leeuwarden, Leeuwarden, Fryslân, The Netherlands.
Infect Genet Evol 2016 08 25;42:66-76. Epub 2016 Apr 25.
Laboratory for Zoonoses and Environmental Microbiology, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands.
In this study we used typing based on the eight multilocus sequence typing scheme housekeeping genes (MLST) and 5S-23S rDNA intergenic spacer (IGS) to explore the population structure of Borrelia burgdorferi sensu lato isolates from patients with Lyme borreliosis (LB) and to test the association between the B. burgdorferi s.l. Read More
MMW Fortschr Med 2016 Mar;158(6):64, 66-7
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, Frauenlobstr. 9-11, D-80337, München, Deutschland.
BMC Infect Dis 2016 Mar 25;16:140. Epub 2016 Mar 25.
National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands.
Background: Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe.
Methods: We searched EMBASE en MEDLINE and contacted experts. Read More
J Am Acad Dermatol 2016 Apr 9;74(4):685-92. Epub 2016 Jan 9.
Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France. Electronic address:
Background: The diagnosis of acrodermatitis chronica atrophicans (ACA), the late cutaneous manifestation of Lyme borreliosis, can be challenging. Histologic changes in ACA have been described in a few studies from endemic countries, relying on cases documented by serology only.
Objectives: We sought to reassess the clinicopathological spectrum of ACA in a series of thoroughly documented cases. Read More
J Pediatr 2016 Mar 10;170:335-e1. Epub 2015 Dec 10.
Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Adv Med Sci 2016 Mar 10;61(1):96-100. Epub 2015 Nov 10.
Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.
Purpose: We evaluated the clinical picture of patients hospitalized with Lyme disease (LD). Additionally, we analyzed the possible cause of sudden rise in LD incidence in Poland.
Materials And Methods: We retrospectively analyzed medical documentation of patients admitted to the Department of Infectious Diseases and Neuroinfections, Medical University in Bialystok in 2013 with suspicion of LD. Read More
J Cutan Pathol 2015 Oct 10;42(10):674-92. Epub 2015 Aug 10.
Dermatologikum Hamburg, Hamburg, Germany.
Background: Chronic cutaneous borreliosis (acrodermatitis chronica atrophicans, ACA) is a relatively rare manifestation of borreliosis attributed mainly to Borrelia afzelii. Chronic borreliosis has been associated with ospA and ospC genotypes. Literature on molecular investigations of Borrelia in lesions of ACA is scant. Read More
Int J Trichology 2015 Jan-Mar;7(1):26-8
Center for Dermatology and Hair Diseases, Zurich-Wallisellen, Switzerland.
A case of acute diffuse and total alopecia of the female scalp associated with Borrelia-infection (acrodermatitis chronica atrophicans) is presented. Today, acute diffuse and total alopecia of the female scalp is recognized as a distinct variant of alopecia areata (AA) predominantly observed in women. Cases of AA have formerly been reported in association with infections. Read More
J Am Acad Dermatol 2015 Apr 21;72(4):683-9. Epub 2015 Jan 21.
Dermatopathologie Friedrichshafen, Friedrichshafen, Germany.
Background: With the exception of erythema migrans, Borrelia infection of the skin manifests much more commonly with B cell-rich infiltrates. T cell-rich lesions have rarely been described.
Objective: We report a series of 6 patients with cutaneous borreliosis presenting with T cell-predominant skin infiltrates. Read More
Ticks Tick Borne Dis 2015 Mar 22;6(2):189-97. Epub 2014 Dec 22.
Department of Infectious Diseases and Neuroinfections, Medical University in Białystok, ul. Żurawia 14, 15-540 Białystok, Poland.
Apoptosis of the lymphocytes plays an essential role in the regulation of inflammatory/immune responses and its abnormalities may contribute to a chronic infection, persistent inflammation and autoimmunity. Its role in the pathogenesis of the late Lyme borreliosis manifestations has not been studied so far. We have measured Th lymphocyte apoptosis rate, membrane expression of pro-apoptotic Fas receptor, and supernatant concentrations of selected soluble pro- and anti-apoptotic mediators in cultures of peripheral blood mononuclear cells from 16 patients with disseminated Lyme borreliosis (6 with osteoarticular symptoms, 7 with neuroborreliosis and 3 with acrodermatitis chronica atrophicans) and 8 healthy controls. Read More
Jpn J Infect Dis 2015 25;68(1):1-4. Epub 2014 Nov 25.
Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention.
Lyme borreliosis is one of the most common tick-borne infections in the northern hemisphere. However, the epidemiological features and clinical manifestations of this disease in Korea are unknown. The present study is the first to investigate the characteristics of Lyme borreliosis in Korea. Read More
Acta Derm Venereol 2015 May;95(5):565-71
Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036 Graz, Switzerland.
The spectrum of skin manifestations of Lyme borreliosis in children is not well characterized. We conducted a retrospective study to analyze the clinical characteristics, seroreactivity to Borrelia burgdorferi sensu lato, and outcome after treatment in 204 children with skin manifestations of Lyme borreliosis seen in 1996-2011. Solitary erythema migrans was the most common manifestation (44. Read More
Acta Dermatovenerol Croat 2014 ;22(3):205-8
Giuseppe Stinco, MD, Institute of Dermatology , University of Udine, Ospedale "San Michele" , Piazza Rodolone 1, 33013 Gemona del Friuli (Udine), Italy ;
Acrodermatitis chronica atrophicans is a rare late manifestation of tick-borne Borrelia burgdorferi infection, manifesting as inflammatory and atrophic lesions on acral skin. We describe the case of a 73-year-old woman with skin changes progressed to marked atrophy on her left hand and an edematous inflammatory involvement of the face. The diagnosis of acrodermatitis chronica atrophicans was made on the basis of clinical appearance, serological and histopathological findings, and the lesional detection of B. Read More
Joint Bone Spine 2015 May 19;82(3):208. Epub 2014 Jul 19.
Dermatology Department, Pasteur Hospital, Colmar, France.
Ann Dermatol Venereol 2014 Jun-Jul;141(6-7):452-7. Epub 2014 Jun 2.
Service de dermatologie, hôpital Haut-Lévêque, CHU de Bordeaux, université de Bordeaux, avenue de Magellan, 33604 Pessac, France. Electronic address:
Background: While a dermal proliferation of monotypic monoclonal lymphocytes and plasma cells suggests above all cutaneous marginal zone lymphoma (CMZL) or plasmacytoma, it may also correspond to a Borrelia infection of which the clinic picture is evocative, as demonstrated in the cases presented herein.
Patients And Methods: The files of two patients were submitted for discussion at the regional multidisciplinary staff meeting on cutaneous lymphomas after review of the skin biopsies led to a diagnosis of plasmacytoma and CMZL on the basis of infiltrate containing abundant plasma cells. The infiltrates of both patients showed a kappa monotypic light chain and cutaneous B-cell clones were detected. Read More
J Mal Vasc 2014 May 31;39(3):212-5. Epub 2014 Mar 31.
Clinique universitaire de médecine vasculaire, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
Lyme disease acrodermatitis chronica atrophicans is a tertiary form of Lyme borrelliosis. It occurs at least six months, but also up to several years, after a tick bite. This rare condition is probably underestimated because of the difficult diagnosis. Read More
ScientificWorldJournal 2014 16;2014:414505. Epub 2014 Jan 16.
Department of Clinical and Experimental Pathology and Medicine, Institute of Dermatology, University of Udine School of Medicin, Ospedale "San Michele," Piazza Rodolone 1, Gemona del Friuli, 33013 Udine, Italy.
Background: Lyme Borreliosis is a multisystemic infection caused by spirochetes of Borrelia burgdorferi sensu lato complex. The features of Lyme Borreliosis may differ in the various geographical areas, primarily between the manifestations found in America and those found in Europe and Asia.
Objective: to describe the clinical features of Lyme Borreliosis in an endemic geographic area such as Friuli-Venezia Giulia in the Northeastern part of Italy. Read More
Br J Dermatol 2014 Sep 27;171(3):528-43. Epub 2014 Aug 27.
Department of Dermatology, Münster University, Von Esmarch Strasse 58, Münster, 48149, Germany.
Background: Lyme borreliosis has a broad spectrum of clinical presentations involving the skin, joints and nervous system. The variable manifestations have been attributed to different Borrelia genospecies but genotyping required culture or fresh tissue. However, in dermatology practice, formalin-fixed paraffin-embedded biopsies are used for dermatopathological examination. Read More
Handb Clin Neurol 2013 ;115:559-75
Department of Neurology, Rigshospitalet, University Clinic Copenhagen, Denmark. Electronic address:
Lyme neuroborreliosis (LNB) designates the nervous system disorders caused by the tick-borne spirochete Borrelia burgdorferi (Bb). The clinical syndromes are usually distinct and are classified as early and the rare late or chronic LNB. Early LNB occurs 3-6 weeks after infection most frequently as a lymphocytic meningoradiculoneuritis (LMR). Read More
PLoS One 2013 30;8(5):e64110. Epub 2013 May 30.
Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia.
Cutaneous manifestations of Lyme borreliosis in Europe include erythema migrans (EM) and acrodermatitis chronica atrophicans (ACA); the most common non-cutaneous manifestations are Lyme neuroborreliosis (LNB) and Lyme arthritis. The purpose of this study was to evaluate the gender distribution of patients with these clinical manifestations of Lyme borreliosis. Data on gender were obtained from the clinical records of patients with Lyme borreliosis aged ≥15 years who had been evaluated at the University Medical Center Ljubljana, Ljubljana, Slovenia. Read More
Indian J Dermatol 2013 May;58(3):167-74
Department of Dermatology, Command Hospital, Pune, Maharashtra, India.
Lyme disease is a multisystem illness which is caused by the strains of spirochete Borrelia burgdorferi sensu lato and transmitted by the tick, Ixodes. Though very commonly reported from the temperate regions of the world, the incidence has increased worldwide due to increasing travel and changing habitats of the vector. Few cases have been reported from the Indian subcontinent too. Read More
Ann Agric Environ Med 2013 ;20(1):21-9
Department of Infectious Diseases and Neuroinfections, Medical University in Białystok, Poland.
Introduction And Objective: Several Borrelia burgdorferi sensu lato species cause Lyme borreliosis throughout Europe and their geographic distribution may influence clinical manifestations of the disease. In Poland, Lyme borreliosis presents mainly with neurologic and cutaneous symptoms, while clinically overt arthritis is rare. The presented study investigates the prevalence of B. Read More
Acta Neurol Scand Suppl 2013 (196):38-47
Department of Neurology, Sørlandet Hospital, Kristiansand, Norway.
In this review, we aim to discuss the definition, clinical and laboratory features, diagnostics, and management of chronic Lyme. Chronic Lyme is a rare condition caused by long-lasting and ongoing infection with the spirochete Borrelia burgdorferi (Bb). The most common manifestations are progressive encephalitis, myelitis, acrodermatitis chronica atrophicans with or without neuropathy, and arthritis. Read More
Am J Dermatopathol 2013 May;35(3):338-42
Research Unit of Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria.
In this study, we describe the clinicopathologic features of pseudolymphomatous infiltrates found within lesions of acrodermatitis chronica atrophicans (ACA). We studied 11 patients (10 females, 1 male, age range 60-88 years). The diagnosis of ACA in all cases was confirmed by clinicopathologic correlation and positive serology for Borrelia. Read More
Int J Dermatol 2012 Nov;51(11):1391
PLoS One 2012 29;7(6):e40046. Epub 2012 Jun 29.
EA 4438, Physiopathologie et Médecine Translationnelle, Facultés de Médecine et de Pharmacie, Université de Strasbourg, Strasbourg, France.
In Lyme borreliosis, the skin is the key site of bacterial inoculation by the infected tick, and of cutaneous manifestations, erythema migrans and acrodermatitis chronica atrophicans. We explored the role of fibroblasts, the resident cells of the dermis, in the development of the disease. Using microarray experiments, we compared the inflammation of fibroblasts induced by three strains of Borrelia burgdorferi sensu stricto isolated from different environments and stages of Lyme disease: N40 (tick), Pbre (erythema migrans) and 1408 (acrodermatitis chronica atrophicans). Read More
Hautarzt 2012 May;63(5):381-9
Klinik für Dermatologie und Allergologie, Technische Universität München, Biedersteinerstr. 29, 80802, München, Deutschland.
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. Read More
Cornea 2013 Jan;32(1):87-90
Institute of Applied Bio-Ophthalmology, University of Valladolid, Valladolid, Spain.
Purpose: To report the case of acrodermatitis chronica atrophicans as an ocularpalpebral manifestation of Lyme borreliosis, with peripheral keratopathy and associated vasculitis.
Methods: Case report.
Results: A 16-year-old girl, with a 4-year history of recurrent left eye photophobia, intense redness, and superior eyelid edema, presented with lid erythema, ptosis, superficial venous tortuosity, conjunctival hyperemia, corneal thinning with precipitates, and vascularization. Read More
Open Neurol J 2012 31;6:179-86. Epub 2012 Dec 31.
Medical Practice for Dermatology, Venerology, Occupational Dermatology and Environmental Medicine, Kempten, Bavaria, Germany.
Lyme Borreliosis, or Lyme's disease, manifests itself in numerous skin conditions. Therapeutic intervention should be initiated as soon as a clinical diagnosis of erythema migrans is made. The histopathology of some of the skin conditions associated with Lyme Borreliosis is characterised by structural changes to collagen, and sometimes also elastic fibres. Read More
Ugeskr Laeger 2011 Dec;173(50):3272-3
Ortopædkirurgisk Afdeling, Køge Sygehus, Lykkebækvej 1, 4600 Køge, Denmark.
A healthy 29 year-old man developed over four years a slowly increasing swelling and violet discolouring of the third toe on his left foot. He was examined by several specialists and an amputation was recommended since the condition was unknown and aggravating. On suspicion of Borrelia infection the patient was prescribed penicillin treatment for 28 days with convincing effect. Read More
Lancet Infect Dis 2011 Oct;11(10):800
Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland.
Pathologe 2011 Sep;32(5):384-90
Labor für Dermatohistologie und Immunfluoreszenzdiagnostik, Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Ricklinger Str. 5, 30449, Hannover, Deutschland.
The seven basic patterns of inflammatory dermatoses according to Ackerman can be applied to infectious dermatoses. However, it should be borne in mind that infection caused by one agent may induce differing patterns according to the stage of disease. Dermatophytosis and the arthropod reaction belong to perivascular dermatoses with spongiosis. Read More
Infection 2011 Feb 10;39(1):35-40. Epub 2010 Dec 10.
Department of Infectious Diseases, University Medical Center Ljubljana, Japljeva 2, Ljubljana, Slovenia.
Background: Reports on patients with European Lyme borreliosis in whom borreliae were isolated from the blood are rare and nearly exclusively limited to those with solitary or multiple erythema migrans. Here we report on patients with other manifestations of Lyme borreliosis in whom borreliae were isolated from their blood.
Patients And Methods: This is a retrospective review of the medical files of patients diagnosed with borrelial lymphocytoma, Lyme neuroborreliosis, Lyme arthritis and acrodermatitis chronica atrophicans at the Department of Infectious Diseases of the UMC Ljubljana, Slovenia, for whom a borrelia blood culture was ordered. Read More
Rev Epidemiol Sante Publique 2010 Oct 13;58(5):339-47. Epub 2010 Aug 13.
Service d'information médicale, épidémiologie et économie de la santé, CHRU de Tours, 37044 Tours cedex 9, France.
Background: To describe the clinical forms and epidemiology of Lyme borreliosis, in French adult patients hospitalized in Indre-et-Loire (Centre region).
Methods: Patients were recruited from standardized discharge summaries collected in the hospital database. All adult patients, hospitalized in public hospitals of the Indre-et-Loire administrative district, over a period of 8 years (1999-2006), who satisfied the European diagnostic criteria of Lyme borreliosis, were included. Read More
Ned Tijdschr Geneeskd 2010 ;154:A2012
Rijnland ziekenhuis, Afd. Interne Geneeskunde, Leiderdorp, the Netherlands.
A 71-year-old man was referred to our outpatient clinic because of arthralgia and swelling of his right hand. He also showed a subcutaneous nodule on his left knee. A second patient, a 57-year-old woman, was referred because of painful skin of her legs. Read More