Müller Kurt E
Medical Practice for Dermatology, Venerology, Occupational Dermatology and Environmental Medicine, Kempten, Bavaria, Germany.
Open Neurol J. 2012 Dec 31;6:179-86. doi: 10.2174/1874205X01206010179. eCollection 2012.
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. These conditions include morphea, lichen sclerosus et atrophicus and acrodermatitis chronica atrophicans. More recently, further skin conditions have been identified by the new microscopic investigation technique of focus floating microscopy: granuloma annulare, necrobiosis lipoidica, necrobiotic xanthogranuloma, erythema annulare centrifugum, interstitial granulomatous dermatitis, cutaneous sarcoidosis and lymphocytic infiltration; these conditions also sometimes cause changes in the connective tissue. In the case of ligaments and tendons, collagen and elastic fibres predominate structurally. They are also the structures that are targeted by Borrelia. The resultant functional disorders have previously only rarely been associated with Borreliosis in clinical practice. Ligamentopathies and tendinopathies, spontaneous ruptures of tendons after slight strain, dislocation of vertebrae and an accumulation of prolapsed intervertebral discs as well as ossification of tendon insertions can be viewed in this light.
莱姆病，即莱姆疏螺旋体病，会表现出多种皮肤病症。一旦临床诊断为游走性红斑，就应立即开始治疗干预。一些与莱姆病相关的皮肤病症的组织病理学特征是胶原蛋白以及有时还有弹性纤维的结构变化。这些病症包括硬斑病、硬化萎缩性苔藓和慢性萎缩性肢端皮炎。最近，通过聚焦浮动显微镜这一新的微观检查技术又发现了更多皮肤病症：环状肉芽肿、类脂质渐进性坏死、坏死性黄色肉芽肿、离心性环状红斑、间质性肉芽肿性皮炎、皮肤结节病和淋巴细胞浸润；这些病症有时也会导致结缔组织发生变化。在韧带和肌腱方面，胶原蛋白和弹性纤维在结构上占主导地位。它们也是疏螺旋体攻击的目标结构。由此产生的功能障碍在临床实践中以前很少与莱姆病相关联。从这个角度来看，可以解释韧带病和肌腱病、轻微拉伤后肌腱的自发性断裂、椎骨脱位、椎间盘突出积聚以及肌腱附着处骨化等情况。
