George Eva, Nielson Colton B, Vincek Vladimir
Department of Dermatology, University of Florida College of Medicine, Gainesville, FL.
Am J Dermatopathol. 2019 Oct;41(10):747-749. doi: 10.1097/DAD.0000000000001290.
Borrelia burgdorferi, the causative organism of Lyme disease, has been linked to the development of scleroatrophic skin conditions including morphea, although this association remains controversial. The possibility that tick bite with or without concurrent Borrelia infection instigates that morphea development is important to recognize because this could prompt further workup for Lyme disease, or other tick-borne illness, which, when untreated, can have devastating consequences. Here, we report a case of a woman with a history of previous tick bite in the location of morphea. This prompted further workup, including serologies that were negative for borrelia. The patient declined empiric treatment with doxycycline. It is important to be aware that morphea may represent a consequence of tick bite because this can alter patient management.
莱姆病的病原体伯氏疏螺旋体与包括硬斑病在内的硬化萎缩性皮肤病的发生有关，尽管这种关联仍存在争议。认识到无论是否同时感染伯氏疏螺旋体，蜱虫叮咬都可能引发硬斑病的发生这一点很重要，因为这可能促使对莱姆病或其他蜱传疾病进行进一步检查，若不治疗，这些疾病可能会产生毁灭性后果。在此，我们报告一例有硬斑病部位既往蜱虫叮咬史的女性病例。这促使进行了进一步检查，包括伯氏疏螺旋体血清学检查结果为阴性。患者拒绝接受强力霉素的经验性治疗。认识到硬斑病可能是蜱虫叮咬的结果很重要，因为这会改变患者的治疗管理。
