Vasudevan Biju, Chatterjee Manas
Department of Dermatology, Command Hospital, Pune, Maharashtra, India.
Indian J Dermatol. 2013 May;58(3):167-74. doi: 10.4103/0019-5154.110822.
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. Skin manifestations are the earliest to occur, and diagnosing these lesions followed by appropriate treatment, can prevent complications of the disease, which are mainly neurological. The three main dermatological manifestations are erythema chronicum migrans, borrelial lymphocytoma and acrodermatitis chronica atrophicans. Many other dermatological conditions including morphea, lichen sclerosus and lately B cell lymphoma, have been attributed to the disease. Immunofluorescence and polymerase reaction tests have been developed to overcome the problems for diagnosis. Culture methods are also used for diagnosis. Treatment with Doxycycline is the mainstay of management, though prevention is of utmost importance. Vaccines against the condition are still not very successful. Hence, the importance of recognising the cutaneous manifestations early, to prevent systemic complications which can occur if left untreated, can be understood. This review highlights the cutaneous manifestations of Lyme borreliosis and its management.
莱姆病是一种多系统疾病，由疏螺旋体伯氏疏螺旋体狭义亚种引起，通过蜱虫（硬蜱属）传播。尽管在世界温带地区报道非常普遍，但由于旅行增加和媒介栖息地变化，全球发病率有所上升。印度次大陆也报告了少数病例。皮肤表现是最早出现的，诊断这些病变并随后进行适当治疗，可以预防该疾病的并发症，主要是神经系统并发症。三种主要的皮肤表现是慢性游走性红斑、疏螺旋体淋巴细胞瘤和慢性萎缩性肢端皮炎。许多其他皮肤病，包括硬斑病、硬化萎缩性苔藓以及最近的B细胞淋巴瘤，都被认为与该疾病有关。已经开发了免疫荧光和聚合酶反应测试来克服诊断问题。培养方法也用于诊断。多西环素治疗是主要的治疗方法，尽管预防至关重要。针对这种疾病的疫苗仍然不是很成功。因此，可以理解早期识别皮肤表现以预防如果不治疗可能发生的全身并发症的重要性。这篇综述强调了莱姆病螺旋体病的皮肤表现及其管理。
