EN: erythema nodosum ENM: erythema nodosum migrans INTRODUCTION Erythema nodosum migrans (ENM) is a rare clinical variant of erythema nodosum (EN). It is a septal panniculitis characterized by asymmetrical, mildly tender, nodules that migrate over time. Fever, sore throat, or arthralgias may also accompany the cutaneous manifestations of the disease; however, this is uncommon. The treatment of ...

European erythema migrans disease, lymphocytoma, and acrodermatitis chronica are a group of disorders associated with the bite of ixodid ticks. These disorders are now thought to be due to a single, or closely related, ixodid tick spirochetes. European erythema migrans disease closely resembles Lyme disease. Serological evaluation may help to separate spirochetal lymphocytoma from other pseudol...

This study was designed to improve the recovery of Borrelia burgdorferi from blood. With the techniques used, B. burgdorferi could be recovered from the blood of approximately 25% of patients with early Lyme disease associated with erythema migrans. Serum was a better source of culture material than whole blood. The volume of blood cultured correlated directly with yield, particularly for patie...

Lyme disease is the most common tick-borne infection in the United States and Europe. A surprising number of patients experience a subsequent episode of Lyme disease after the first episode has resolved. Reinfection has been well-documented only after successfully treated early infection (nearly always erythema migrans) and can often be recognized clinically by the development of a repeat episo...

We tested the hypothesis that cross-reactivity between the outer surface protein A (OspA) of Borellia burgdorferi and human leukocyte function antigen (LFA) type 1 mediates chronic autoimmune sequelae of Lyme disease. T cell response was studied in subjects with Lyme disease presenting with erythema migrans alone (n=36), erythema migrans with neurological disease (n=12), and chronic Lyme diseas...

2 mm thickness [1] . It is a relatively specific sign for cryptogenic organizing pneumonia [1, 2] , but the differential diagnosis list should also include: bacterial pneumonia, lymphomatoid granulomatosis, Wegener’s granulomatosis, tuberculosis, mucormycosis, paracoccidioidomycosis, sarcoidosis, cancer and pulmonary infarction. Although the pathogenesis of the ‘reversed halo sign’ is not yet u...

This manuscript describes the typical presentation of erythema migrans caused by tick bite. The purposes of this article are (i) to encourage physicians to observe patients with tick bite carefully since it may cause fatal encephalitis, and (ii) to facilitate physicians, especially in endemic areas, to consider tick-borne encephalitis virus as one of the causes of encephalitis.

An 18-year-old man with developmental disability presented with a circular, erythematous red rash (pictured) with central clearing that measured 5 cm in diameter. The rash developed on his abdomen 9 days after his father removed a small tick from the area where the rash appeared. His parents were unaware of how long the tick had been attached. The patient had several recent outdoor exposures wh...

To investigate the duration and kinetics of immunoglobulin M (IgM) and IgG antibodies against Borrelia burgdorferi in serum after treatment of Lyme borreliosis, consecutive serum samples from 30 seropositive patients with erythema migrans and 91 seropositive patients with neuroborreliosis were analyzed with a capture IgM enzyme-linked immunosorbent assay (ELISA) and an indirect IgG ELISA, both ...