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Fiction and Fact about the Lyme rash

Chemotherapy. 2006 Feb 22;52(2):53-59

Fiction: "About 70-80%" of Lyme disease patients present with a characteristic 'bulls-eye' erythema migrans (EM) rash.

Fact: According to recent health department statistics from Texas, Connecticut and California, only 35-59% of Lyme disease patients present with an EM rash, and the rate may be even lower depending on the location of the tick bite and the awareness of the person who was bitten [29, 30] .

The published incidence of the EM rash also reflects a type of circular reasoning that pervades Lyme disease research: since the presence of an EM rash is the best evidence for Lyme disease, it has become the most common criterion for admission into Lyme disease studies. Since most patients in these studies have an EM rash, the incidence of the rash becomes inflated in the medical literature. The literature then perpetuates the myth that the vast majority of Lyme disease patients have an EM rash [4, 26] .

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