Isolation of Borrelia afzelii from circumscribed scleroderma.

A 45-year-old man presented with circumscribed scleroderma (CS) on the extremities. Histology of lesional skin showed the typical manifestations of scleroderma including a perivascular and interstitial infiltrate of lymphocytes and plasma cells; in one of the biopsies spirochaetes could be detected. Despite treatment with penicillin, progression of CS was observed and spirochaetes were isolated from skin cultures obtained from active scleroderma lesions.