Cutaneous manifestations of Lyme borreliosis

The cutaneous manifestations of Lyme disease have been known for more than 100 years and are specified as different diseases. All of them show similar pathophysiological mechanisms. After invasion of the borrelial pathogen, the cellular immune response leads to noticeable changes in the skin that usually proceed without epidermal involvement. In most cases, the manifestations in early local infection (erythema migrans, borrelial lymphocytoma) do not yet lead to a measurable antibody response, whereas acrodermatitis chronica atrophicans as a classical manifestation in late persistent infection regularly shows a massive increase in IgG antibody titers. All of these Borrelia-associated skin manifestations can be quickly diagnosed by clinical inspection.The therapy follows standardized schemes and in most cases, can cure the disease.