Thursday, July 25, 2013

Lyme (borreliosis) and Your Skin

I've been noticing weird stuff happen to my skin the last few years:

1. Additional pigmentation around my lower right leg,
2. Lots of new spider veins on my thighs appearing relatively quickly. This started recently.
3. Very rapid onset of wrinkles on the backs of my hands.
4. Increased transparency of skin on my hands, especially. 
5. Leatherlike skin on the soles of my feet.

I have been told by my LLMD that Bartonella can do some of this, especially the spider veins. Whatever the cause(s), my interest perked up when I found the following citation:

Lyme borreliosis and skin.

Authors: Vasudevan B, Chatterjee M

Citation: Indian J Dermatol 2013(May); 58(3): 167-74.

Location: Department of Dermatology, Command Hospital, Pune, Maharashtra, India.

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 sclerosis 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 recognizing 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.


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