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Skin Changes in Suspected Lyme Disease.

Acta Dermatovenerol Croat

December 2023

Pero Vržogić, MD, Naftalan Special Hospital for Medical Rehabilitation, Ivanić Grad, Croatia;

Article Synopsis
  • Ticks are a significant health concern in Croatia and worldwide due to their role in transmitting various diseases, including Lyme borreliosis, which is caused by the Borrelia burgdorferi bacterium.
  • In Croatia, the incidence rate of Lyme borreliosis is approximately 6.51 cases per 100,000 people, highlighting the risk of infection from ticks.
  • The article describes a case of a 58-year-old woman with Lyme disease who had skin manifestations that fully regressed after successful treatment, demonstrating the importance of early diagnosis and intervention.
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Background: Tick-borne illnesses and methemoglobinemia have not been known to occur together in humans. Few cases have been documented in various animals of methemoglobinemia secondary to tick-borne infections.

Case Report: A 49-year-old man with no significant medical history presented to the emergency department from an urgent care with hypoxia saturating in the mid 80s.

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Article Synopsis
  • Primary cutaneous marginal zone lymphoma (PCMZL) is a low-grade B-cell lymphoma that occurs in the skin, often showing up as red papules, nodules, or plaques.
  • It is linked to chronic antigenic stimulation from sources like tick-borne bacteria, vaccines, or tattoos, and may develop following conditions like cutaneous lymphoid hyperplasia due to ongoing inflammation.
  • Recent research has improved diagnostics for PCMZL by identifying genetic abnormalities and revealing associations with gastrointestinal disorders, such as Helicobacter pylori and inflammatory bowel disease, illustrated by a case of a patient with ulcerative colitis evolving into PCMZL.
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Erythema migrans, an expanding erythematous skin lesion that develops days to weeks following an Ixodes species tick bite, is the most common clinical manifestation of Lyme disease. Presentations in the United States differ somewhat from that in Europe, presumably because of the different etiologic agents. Diagnosis is based on the appearance of the skin lesion, rather than on laboratory testing.

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Since its emergence in December 2019, coronavirus disease 2019 (COVID-19) has been detrimental worldwide. Although COVID-19 infection is primarily known for its respiratory manifestations, extrapulmonary features are increasingly being reported. Among these, cutaneous manifestations are apparent but have a high likelihood of not being attributed to COVID-19.

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