Erythema Migrans and Interface Changes: More Than a Fortuitous Association
In this study, cases submitted with a serologically confirmed, clinically unequivocal, or highly suspicious diagnosis of ECM/Lyme disease between January 01, 2016, and September 01, 2018, were retrieved from the electronic database system and reviewed to delineate the histopathologic features of ECM. The series consisted of 14 cases. A superficial perivascular lymphocytic infiltrate was noted in all biopsies, accompanied by a deep and/or interstitial inflammatory infiltrate in 9 cases (64%). The inflammation ranged from relatively sparse to dense and prominent. At least focal interface changes were noted in 12 biopsies (86%). Eosinophils and plasma cells were noted in 7 (50%) and 10 (71%) cases, respectively. From a histologic standpoint, ECM is a protean entity and may manifest with a variable density of perivascular and/or interstitial lymphocytic infiltrate admixed with eosinophils and/or plasma cells and accompanied by focal interface dermatitis. Within the appropriate clinical context, ECM should be considered in the differential diagnosis of focal interface and/or sparse perivascular dermatitis.
Introduction: Acrodermatitis chronica atrophicans (ACA) is a late cutaneous manifestation of Lyme disease characterized by inflammatory lesions that slowly progress to atrophic plaques. The vast majority of ACA cases have been described in Europe and are associated to the genospecies Borrelia afzelii (B. afzelii). We hereby report the first case in Northern Mexico of ACA caused by locally acquired B. afzelii.
A 6-year-old girl was presented with a rash on the left side of her face (Fig. 1a). Her primary care pediatrician assumed this to be allergic dermatitis and treated it with topical steroids, but there was no improvement. Over the next 1.5 months, the rash spread to the back of the head (Fig. 1b). The patient also had systemic manifestations, including low-grade fever (up to 37.7 °C) and malaise. Because the patient lived in an endemic area, the rash was deemed suspicious for erythema migrans associated with Lyme disease.
Publication date: Available online 30 January 2019Source: Veterinary ParasitologyAuthor(s): David W. Ramilo, Carla Monteiro, Marrion Carreira, Isabel Pereira da Fonseca, Luís CardosoAbstractTrombiculids parasitize a wide variety of terrestrial vertebrates, including domestic animals, throughout the world. They are parasites only during their larval stages, causing several dermatological lesions on their hosts, such as acute dermatitis, erythema, excoriation, erosion, papules, crusts and alopecia on the ear margins, face, interdigital spaces and abdomen. Neotrombicula is one of the several genera in Trombiculidae fam...
We present 3 cases of dermatitis artefacta with distinct clinical and histologic features. The first case was that of a 12-year-old right-handed boy presenting with a unilateral linear eruption involving the left arm. Histopathology revealed an unusual pattern of epidermal necrosis. Lyme serology and immunofluorescence were negative. He eventually voluntarily admitted that this was self-inflicted and was referred to the local child and adolescent mental health services. The second case involved a 37-year-old woman with Fowler syndrome presenting acutely with an extensive annular blistering rash sparing her back and posterior legs.
This study reveals disparate results in terms of dog exposure to fleas and ticks in the studied communities, which may be related to factors such as the owners’ capability/willingness to afford the use of ectoparasiticides on their dogs and level of restriction. Further research is needed to establish the relationship between dog owners’ socioeconomic situation and the level of exposure to ectoparasites and their transmitted pathogens.
For SELF, by Amy Marturana. Regardless of your skin type, chances are you’ve had an itchy, red, bumpy rash at one time or another. It’s like the international sign of skin irritation. If it’s not affecting your daily life or covering whole body, and you’re not feeling sick otherwise, chances are it’s nothing to worry about and will clear up on its own, Rebecca Kazin, M.D., dermatologist and associate director at the Washington Institute of Dermatologic Laser Surgery, tells SELF. Treating it with over-the-counter hydrocortisone itch relief cream until it goes away may be sufficient. “But...
In this study, the authors present a 9-year-old girl with linear arrangement of subcutaneous nodules on her left forearm. Microscopic findings from 2 biopsies included lymphocytes at the dermoepidermal junction with mild interface dermatitis, a dense lymphocytic infiltrate that was concentrated around adnexae and subcutaneous fat in concert with thickened collagen bundles and mild widening of fibrous septae surrounding fat lobules. Although the clinical differential diagnosis included panniculitis or a sporotrichoid infection, 1 biopsy showed a dense lymphocytic infiltrate histologically bordered on that of cutaneous lymph...
Abstract A 70-year-old man was referred by his rheumatologist to our dermatology clinic for evaluation of dermatitis on his right arm that appeared 3 months earlier. The skin lesion was asymptomatic and the patient denied current systemic symptoms, including fever, chills, and joint pain; however, 10 months prior to this presentation he experienced arthritis in the left knee. At that time, Borrelia serology revealed positive IgG (6.07;
CONCLUSIONS: Clinical diagnosis of PNGD is difficult, and is based mainly on the histopathological picture. Systemic therapy is incorporated mainly due to the systemic disease. The patient requires further observation in the direction of associated systemic disorders. PMID: 27294654 [PubMed - in process]
Conclusions: From the two cases presented here, it does appear that sodium ceftriaxone can induce anaphylactoid reactions in horses infected by Borrelia burgdorferi, which may evolve into colic syndrome, laminitis and the occurrence of opportunistic infections. However, further evidence should be collected in order to draw definite conclusions.