Erythema chronicum migrans and Lyme disease.

Lyme disease is an inflammatory disorder with a wide spectrum of clinical manifestations that involve the skin, joints, heart, and nervous system (1-4). Initially described in 1977 and named after the rural town in Connecticut where the first cases were detected in 1975, Lyme disease has now been recognized in at least 24 states (5-7), Canada (8), Australia (9), France (10), Switzerland (11), and Germany (12), and in individuals who travel to or spend time in areas known to be endemic for this disorder (13).