Feder H M, Whitaker D L
Department of Pediatrics, University of Connecticut Health Center, Farmington 06030, USA.
Am J Med. 1995 Oct;99(4):412-9. doi: 10.1016/s0002-9343(99)80190-9.
Erythema migrans is a clinical diagnosis that carries possible long-term repercussions. Despite widespread awareness of the clinical presentation of erythema migrans, incorrect diagnosis occurs.
We describe 13 cases in which erythema migrans was misdiagnosed and discuss some pitfalls in diagnosis. These cases were seen at a tertiary referral center in Connecticut, a state where Lyme disease is endemic. The patients selected for inclusion were those who most clearly illustrate potential difficulties involved in making the diagnosis of erythema migrans.
The diagnosis of erythema migrans was missed in 5 patients due to atypical presentations. Eight patients with skin eruptions closely mimicking erythema migrans were incorrectly diagnosed with erythema migrans.
There are pitfalls associated with the diagnosis of erythema migrans that may result in overdiagnosis or underdiagnosis.
游走性红斑是一种具有潜在长期影响的临床诊断。尽管人们对游走性红斑的临床表现普遍有所认识，但仍会出现误诊情况。
我们描述了13例游走性红斑被误诊的病例，并讨论了诊断中的一些陷阱。这些病例来自康涅狄格州的一家三级转诊中心，该州是莱姆病的流行地区。入选的患者是那些最能清楚说明游走性红斑诊断中潜在困难的患者。
5例患者因表现不典型而漏诊游走性红斑。8例皮疹酷似游走性红斑的患者被错误诊断为游走性红斑。
游走性红斑的诊断存在一些陷阱，可能导致过度诊断或诊断不足。
