Or...Search this site Home Symptoms Live Discussion Diagnosis Treatment Area Support Library Research Lymelinks Contact Pets & Lyme DONATIONS Drug Info Medical Dictionary Board of Directors      Click on the graphic to vote for this site as a Starting Point Hot Site. -- No Warranties or Representations The data and information presented in this web site are presented in good faith and believed to be accurate. Any and all liability for the content or any omissions including any inaccuracies, errors, or misstatements in such data or information is expressly disclaimed. The web site is compiled for the sole purpose of informing community members of resources and information pertaining to Lyme Borreliosis Disease and its coinfections. The Canadian Lyme Disease Foundation, Directors and members are not liable for any direct or indirect damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action arising out of or in connection with the use or performance of information available from this website. Consult a qualified Lyme ( Borreliosis ) Disease literate doctor for medical advice if Lyme Disease is suspect. en français For Physicians Ticks Coinfections Prevention Our Stories Click Here to order our free Lyme Disease Flyer,    Here for our free Lyme Disease Poster ..documents may be copied (to distribute) but edit only for alignment. Rash Info Borrelia burgdorferi lesions may present with "peculiar" cutaneous manifestations resembling the inflammatory stage of morphea, Spanish physicians report. Therefore, Dr. Carmen Moreno, Universidad Autnoma, Madrid, and colleagues advise that, in areas endemic for B. burgdorferi, biopsy samples from such lesions should be tested with a highly sensitive polymerase chain reaction enzyme-linked immunosorbent assay (PCR-ELISA) In the Journal of the American Academy of Dermatology for March, Dr. Moreno and associates note that cutaneous manifestations of Lyme disease include early erythema chronicum migrans and later acrodermatitis chronica atrophicans. They describe 11 patients with unusual presentation. Six patients had multiple large erythematous cutaneous patches on the trunk or extremities or both. The lesions had evolved over several months and were either stationary or slowly progressing. The other five patients presented a solitary, usually indurated, plaque-like lesion, primarily on the trunk. "The histopathologic findings were similar in all cases and consisted of an interstitial inflammatory infiltrate mostly composed of histiocytes dispersed among the collagen bundles of the dermis and focal areas of small pseudorosette formation, characterized by small histiocytes radially disposed around thick collagen bundles," according to the authors' summary. Serology tests for IgM and IgG-ELISA were negative or inconclusive, but biopsy specimens from six patients were positive according to standard PCR. The other five patients were positive according to PCR-ELISA testing. One case was PCR-positive in a first biopsy but negative thereafter in two specimens procured after antibiotic treatment. Because the number of spirochetes may be small in long-standing infection, Dr. Moreno and her colleagues recommend that biopsies should be taken from the outer margins of lesions where they are most concentrated. J Am Acad Dermatol 2003;48:376-384.