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1

García-Souto, Fernando, Isabel Maria Coronel-Perez, and Jeronimo Escudero-Ordoñez. "Erythema migrans." Medicina Clínica (English Edition) 156, no. 2 (2021): 103. http://dx.doi.org/10.1016/j.medcle.2019.10.018.

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2

Masters, Edwin J. "Erythema migrans." Postgraduate Medicine 94, no. 1 (1993): 133–42. http://dx.doi.org/10.1080/00325481.1993.11945684.

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3

Wilson, Thomas C., Allison Legler, Kathi C. Madison, Janet A. Fairley, and Brian L. Swick. "Erythema Migrans." American Journal of Dermatopathology 34, no. 8 (2012): 834–37. http://dx.doi.org/10.1097/dad.0b013e31825879be.

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4

Edlow, Jonathan A. "Erythema migrans." Medical Clinics of North America 86, no. 2 (2002): 239–60. http://dx.doi.org/10.1016/s0025-7125(03)00085-3.

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5

Berger, Bernard W. "Erythema migrans." Clinics in Dermatology 11, no. 3 (1993): 359–62. http://dx.doi.org/10.1016/0738-081x(93)90090-y.

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6

Dandache, Patricia, and Robert B. Nadelman. "Erythema Migrans." Infectious Disease Clinics of North America 22, no. 2 (2008): 235–60. http://dx.doi.org/10.1016/j.idc.2007.12.012.

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7

Nadelman, Robert B. "Erythema Migrans." Infectious Disease Clinics of North America 29, no. 2 (2015): 211–39. http://dx.doi.org/10.1016/j.idc.2015.02.001.

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8

Castiñeiras González, Jose, Eduardo Varas Meis, and Manuel Ángel Rodríguez Prieto. "Chronic erythema migrans." Medicina Clínica (English Edition) 156, no. 11 (2021): 586–87. http://dx.doi.org/10.1016/j.medcle.2020.05.033.

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9

Campalani, E., and E. Higgins. "Erythema nodosum migrans." Clinical and Experimental Dermatology 28, no. 6 (2003): 679–80. http://dx.doi.org/10.1046/j.1365-2230.2003.01399.x.

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10

Lee, UH, JH Yang, DK Chun, and JC Choi. "Erythema nodosum migrans." Journal of the European Academy of Dermatology and Venereology 19, no. 4 (2005): 519–20. http://dx.doi.org/10.1111/j.1468-3083.2004.01183.x.

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11

Muhlemann, M. F. "Erythema Chronicum Migrans." Journal of the Royal Society of Medicine 80, no. 11 (1987): 705–6. http://dx.doi.org/10.1177/014107688708001116.

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12

Munteanu, Oxana, Dumitru Chesov, Doina Rusu, Christoph Lange, and Victor Botnaru. "Pulmonary Erythema Migrans?" Respiration 87, no. 3 (2014): 252–53. http://dx.doi.org/10.1159/000357323.

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13

Siegel, R., R. Linse, and Beate Rau. "Erythema necrolyticum migrans." Der Chirurg 77, no. 6 (2006): 535–38. http://dx.doi.org/10.1007/s00104-005-1122-y.

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14

Mishra, Ajay Kumar, Zeba Hashmath, Issam Oneyssi, and Abhishek Bose. "Disseminated Erythema Migrans." American Journal of Medicine 133, no. 7 (2020): e374-e375. http://dx.doi.org/10.1016/j.amjmed.2019.12.051.

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15

Goldberg, Neil S. "Vesicular Erythema Migrans." Archives of Dermatology 128, no. 11 (1992): 1495. http://dx.doi.org/10.1001/archderm.1992.01680210073010.

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16

Goldberg, N. S. "Vesicular erythema migrans." Archives of Dermatology 128, no. 11 (1992): 1495–98. http://dx.doi.org/10.1001/archderm.128.11.1495.

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17

Aucott, John N., Lauren A. Crowder, Victoria Yedlin, and Kathleen B. Kortte. "Bull’s-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans." Dermatology Research and Practice 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/451727.

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Introduction. Lyme disease is an emerging worldwide infectious disease with major foci of endemicity in North America and regions of temperate Eurasia. The erythema migrans rash associated with early infection is found in approximately 80% of patients and can have a range of appearances including the classic target bull’s-eye lesion and nontarget appearing lesions.Methods. A survey was designed to assess the ability of the general public to distinguish various appearances of erythema migrans from non-Lyme rashes. Participants were solicited from individuals who visited an educational website about Lyme disease.Results. Of 3,104 people who accessed a rash identification survey, 72.7% of participants correctly identified the classic target erythema migrans commonly associated with Lyme disease. A mean of 20.5% of participants was able to correctly identify the four nonclassic erythema migrans. 24.2% of participants incorrectly identified a tick bite reaction in the skin as erythema migrans.Conclusions. Participants were most familiar with the classic target erythema migrans of Lyme disease but were unlikely to correctly identify the nonclassic erythema migrans. These results identify an opportunity for educational intervention to improve early recognition of Lyme disease and to increase the patient’s appropriate use of medical services for early Lyme disease diagnosis.
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18

Dammin, G. J. "Erythema Migrans: A Chronicle." Clinical Infectious Diseases 11, no. 1 (1989): 142–51. http://dx.doi.org/10.1093/clinids/11.1.142.

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19

&NA;. "Erythema Migrans and Pregnancy." Pediatric Infectious Disease Journal 15, no. 11 (1996): 662. http://dx.doi.org/10.1097/00006454-199611000-00003.

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20

Collins, Jeffrey J. "Treatment of Erythema Migrans." Annals of Internal Medicine 126, no. 5 (1997): 408. http://dx.doi.org/10.7326/0003-4819-126-5-199703010-00013.

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21

Patmas, Michael A. "Treatment of Erythema Migrans." Annals of Internal Medicine 126, no. 5 (1997): 408. http://dx.doi.org/10.7326/0003-4819-126-5-199703010-00014.

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22

Luft, Benjamin J. "Treatment of Erythema Migrans." Annals of Internal Medicine 126, no. 5 (1997): 408. http://dx.doi.org/10.7326/0003-4819-126-5-199703010-00015.

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23

Feder, Henry M., and Diane L. Whitaker. "Misdiagnosis of erythema migrans." American Journal of Medicine 99, no. 4 (1995): 412–19. http://dx.doi.org/10.1016/s0002-9343(99)80190-9.

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24

Norton, Scott A. "Diagnosis of Erythema Migrans." JAMA 298, no. 10 (2007): 1159. http://dx.doi.org/10.1001/jama.298.10.1159-b.

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25

Shimamura, Yoshinosuke, Takuto Maeda, and Yufu Gocho. "Tick bite-Erythema migrans." Journal of General and Family Medicine 19, no. 2 (2018): 59–60. http://dx.doi.org/10.1002/jgf2.152.

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26

Malov, V. A., V. V. Maleev, D. S. Sarksyan, V. P. Chulanov, K. T. Umbetova, and A. N. Gorobchenko. "Cutaneous lesions in ixodal tick-borreliosis (Lyme disease)." Infekcionnye bolezni 23, no. 1 (2025): 95–102. https://doi.org/10.20953/1729-9225-2025-1-95-102.

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The review article is devoted to the description of clinical manifestations of cutaneous lesions in ixodes tick-borreliosis (Lyme disease) at different stages of the disease. A detailed clinical, pathogenetic and morphological characterization of such lesions as erythema migrans, multiple erythema migrans, borreliosis skin lymphocytoma, chronic atrophic acrodermatitis is given. Several other skin lesions that could possibly be associated with ixode tick borreliosis are also discussed. The authors note with which diseases it is necessary to make a differential diagnosis of the skin lesions under consideration, and characterize the key principles of diagnosis. Key words: ixode tick-borreliosis, Lyme disease, skin lesions, erythema migrans, multiple erythema migrans, borreliosis lymphocytoma, chronic atrophic acrodermatitis
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27

Jeker, Weber, Schulthess, and Furrer. "Multilokuläre grosse Erytheme und Fieber." Praxis 94, no. 46 (2005): 1815–19. http://dx.doi.org/10.1024/0369-8394.94.46.1815.

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Ein 44-jähriger Mann suchte drei Monate nach einem Ferienaufenthalt in Sri Lanka die Notfallstation auf. Nach einer kurzen Fieberepisode hatten sich bei ihm vier grossflächige hellrote Hautläsionen entwickelt, die sich unter zentraler Abblassung zentrifugal ausbreiteten. Wir erwogen eine Infektion mit Borrelia burgdorferi (Erythema migrans), Streptokokken (Erysipel) oder Pilzen (Tinea corporis). Der langsam progrediente, wenig entzündliche Verlauf sprach allerdings gegen ein Erysipel, im Direktpräparat liess sich mikroskopisch kein Pilzbefall nachweisen. Der Aspekt der Hautläsionen war typisch für ein Erythema migrans, allerdings waren wir nicht mit einer multilokulären Präsentation dieser Erkrankung vertraut. Dennoch diagnostizierten wir – aufgrund des klinischen Bildes und des serologischen Nachweises von IgM gegen Borrelia burgdorferi – ein multilokuläres Erythema migrans und therapierten mit Doxycyclin 2x 100 mg täglich per os während 10 Tagen. Die Hautläsionen verschwanden innerhalb weniger Tage vollständig. Das Erythema migrans kann sich uni- oder multilokulär manifestieren, abhängig von der Borrelienspezies. In Europa (vorwiegend B. afzelii und B. garinii) ist die multilokuläre Manifestation selten und wird deshalb oft verkannt. Sie basiert auf einer frühen hämatogenen Disseminierung, weshalb Diagnosestellung und Einleitung einer Therapie wichtig sind. In Amerika (B. burgdorferi sensu stricto) präsentiert sich die Borreliose oft systemisch, u.a. mit multilokulärem Erythema migrans.
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28

Maraspin, Vera, Petra Bogovič, Tereza Rojko, Katarina Ogrinc, Eva Ružić-Sabljić, and Franc Strle. "Early Lyme Borreliosis in Patients Treated with Tumour Necrosis Factor-Alfa Inhibitors." Journal of Clinical Medicine 8, no. 11 (2019): 1857. http://dx.doi.org/10.3390/jcm8111857.

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The study evaluated the course and outcome of erythema migrans in patients receiving tumour necrosis factor-alpha (TNF-α) inhibitors. Among 4157 adults diagnosed with erythema migrans in the period 2009–2018, 16 (2.6%) patients were receiving TNF-α inhibitors (adalimumab, infliximab, etarnecept, golimumab), often in combination with other immunosuppressants, for rheumatic (13 patients) or inflammatory bowel (three patients) disease. Findings in this group were compared with those in 32 sex- and age-matched immunocompetent patients diagnosed with erythema migrans in the same years. In comparison with the control group, the immunocompromised patients had a shorter incubation period (7 vs. 14 days; p = 0.0153), smaller diameter of erythema migrans (10.5 vs. 15.5 cm; p = 0.0014), and more frequent comorbidities other than immune-mediated diseases (62.5% vs. 25%, p = 0.0269), symptoms/signs of disseminated Lyme borreliosis (18.8% vs. 0%, p = 0.0324), and treatment failure (25% vs. 0%, p = 0.0094). After retreatment with an antibiotic, the clinical course of Lyme borreliosis resolved. Continuing TNF inhibitor treatment during concomitant borrelial infection while using identical approaches for antibiotic treatment as in immunocompetent patients resulted in more frequent failure of erythema migrans treatment in patients receiving TNF inhibitors. However, the majority of treatment failures were mild, and the course and outcome of Lyme borreliosis after retreatment with antibiotics was favourable.
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29

Mateus, Anna Beatriz Andrade, Luana Elisa De Castro Gonçalves, Giovanna Lopes Lanza, Soraya De Mattos Camargo Grossmann Almeida, Martinho Campolina Rebello Horta, and Leandro Junqueira De Oliveira. "ERYTHEMA MIGRANS—AN UNCOMMON CASE." Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 134, no. 3 (2022): e148. http://dx.doi.org/10.1016/j.oooo.2022.01.362.

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30

Ackermann, R., U. Runne, W. Klenk, and C. Dienst. "Erythema chronicum migrans mit Arthritis." DMW - Deutsche Medizinische Wochenschrift 105, no. 51 (2008): 1779–81. http://dx.doi.org/10.1055/s-2008-1070958.

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31

Lucas, V. S., S. J. Challacombe, and P. R. Morgan. "Erythema migrans: an unusual presentation." British Dental Journal 175, no. 7 (1993): 258–59. http://dx.doi.org/10.1038/sj.bdj.4808293.

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32

Weber, K., G. Schierz, Bettina Wilske, et al. "Reinfection in erythema migrans disease." Infection 14, no. 1 (1986): 32–34. http://dx.doi.org/10.1007/bf01644807.

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33

Wetter, D. A., and C. A. Ruff. "Erythema migrans in Lyme disease." Canadian Medical Association Journal 183, no. 11 (2011): 1281. http://dx.doi.org/10.1503/cmaj.101533.

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34

Aberer, Elisabeth, Bernd Leinweber, and Werner Aberer. "Erythema migrans mimicking early morphea." JDDG: Journal der Deutschen Dermatologischen Gesellschaft 18, no. 11 (2020): 1325–27. http://dx.doi.org/10.1111/ddg.14320.

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35

Stark, I., C. H. Mensing, and C. A. Sander. "Erythema necroticans migrans bei Glucagonomsyndrom." Der Hautarzt 59, no. 1 (2007): 50–53. http://dx.doi.org/10.1007/s00105-007-1351-8.

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36

Wagner, G., S. Bartsch, C. Rose, and M. M. Sachse. "Erythema migrans arciforme et palpabile." Der Hautarzt 63, no. 12 (2012): 965–68. http://dx.doi.org/10.1007/s00105-012-2436-6.

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37

Tanner, M., J. Brasch, and E. Christophers. "Erythema necroticans migrans ohne Glukagonom." Der Hautarzt 45, no. 7 (1994): 480–83. http://dx.doi.org/10.1007/s001050050109.

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38

Naktin, Jaan Peter. "Diagnostic Utility of Erythema Migrans." Clinical Infectious Diseases 65, no. 12 (2017): 2156–57. http://dx.doi.org/10.1093/cid/cix544.

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39

Konstantinow, Alexander, Hans Starz, and Bernd-R�diger Balda. "Erythema necrolyticum migrans nach Rektumadenokarzinom." Der Hautarzt 49, no. 7 (1998): 591–95. http://dx.doi.org/10.1007/s001050050795.

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40

Tibbles, Carrie, and Jonathan Edlow. "Diagnosis of Erythema Migrans—Reply." JAMA 298, no. 10 (2007): 1159. http://dx.doi.org/10.1001/jama.298.10.1160-a.

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41

Feder, Henry M. "The Truth About Erythema Migrans." Archives of Dermatology 133, no. 1 (1997): 93. http://dx.doi.org/10.1001/archderm.1997.03890370099015.

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42

Feder, H. M. "The truth about erythema migrans." Archives of Dermatology 133, no. 1 (1997): 93–94. http://dx.doi.org/10.1001/archderm.133.1.93.

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43

Masters, E. J. "Erythema Migrans in the South." Archives of Internal Medicine 158, no. 19 (1998): 2162–65. http://dx.doi.org/10.1001/archinte.158.19.2162.

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44

Müllegger, Robert R., Terry K. Means, Junghee J. Shin, et al. "Chemokine Signatures in the Skin Disorders of Lyme Borreliosis in Europe: Predominance of CXCL9 and CXCL10 in Erythema Migrans and Acrodermatitis and CXCL13 in Lymphocytoma." Infection and Immunity 75, no. 9 (2007): 4621–28. http://dx.doi.org/10.1128/iai.00263-07.

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ABSTRACT The three skin disorders of Lyme borreliosis in Europe include erythema migrans, an acute, self-limited lesion; borrelial lymphocytoma, a subacute lesion; and acrodermatitis chronica atrophicans, a chronic lesion. Using quantitative reverse transcription-PCR, we determined mRNA expression of selected chemokines, cytokines, and leukocyte markers in skin samples from 100 patients with erythema migrans, borrelial lymphocytoma, or acrodermatitis chronica atrophicans and from 25 control subjects. Chemokine patterns in lesional skin in each of the three skin disorders included low but significant mRNA levels of the neutrophil chemoattractant CXCL1 and the dendritic cell chemoattractant CCL20 and intermediate levels of the macrophage chemoattractant CCL2. Erythema migrans and particularly acrodermatitis lesions had high mRNA expression of the T-cell-active chemokines CXCL9 and CXCL10 and low levels of the B-cell-active chemokine CXCL13, whereas lymphocytoma lesions had high levels of CXCL13 and lower levels of CXCL9 and CXCL10. This pattern of chemokine expression was consistent with leukocyte marker mRNA in lesional skin. Moreover, using immunohistologic methods, CD3+ T cells and CXCL9 were visualized in erythema migrans and acrodermatitis lesions, and CD20+ B cells and CXCL13 were seen in lymphocytoma lesions. Thus, erythema migrans and acrodermatitis chronica atrophicans have high levels of the T-cell-active chemokines CXCL9 and CXCL10, whereas borrelial lymphocytoma has high levels of the B-cell-active chemokine CXCL13.
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45

Hansen, K., A. Hovmark, A. M. Lebech, et al. "Roxithromycin in Lyme borreliosis: discrepant results of an in vitro and in vivo animal susceptibility study and a clinical trial in patients with erythema migrans." Acta Dermato-Venereologica 72, no. 4 (1992): 297–300. http://dx.doi.org/10.2340/0001555572297300.

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A new semisynthetic macrolide roxithromycin was evaluated for its potential use in the treatment of Lyme borreliosis. Using a macro-dilution broth technique, Borrelia burgdorferi was shown to be susceptible to roxithromycin with a minimal bactericidal concentration (MBC) of 0.06-0.25 microgram/ml. A systemic B. burgdorferi infection was established in gerbils a dosage of greater than or equal to 25 mg/kg/day roxithromycin for 10 days eliminated the infection. A single blind, randomized multicenter study was performed to evaluate the efficacy of roxithromycin 150 mg b.i.d. versus phenoxymethyl-penicillin 1 g b.i.d. for 10 days in patients with uncomplicated erythema migrans. The study was interrupted when 19 patients had enrolled because of five treatment failures. All 5 patients had received roxithromycin three patients had persisting or recurrent erythema migrans, one developed a secondary erythema migrans-like lesion and severe arthralgia and one developed neuroborreliosis. B. burgdorferi was isolated from skin biopsies after roxithromycin therapy from two patients with persistent erythema migrans and both isolates were still highly susceptible to roxithromycin (MBC = 0.03 microgram/ml). No treatment failures were seen in 10 patients treated with phenoxymethyl-penicillin. Roxithromycin is thus not recommended for treatment of Lyme borreliosis.
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46

Brettschneider, S., H. Bruckbauer, N. Klugbauer, and H. Hofmann. "Diagnostic Value of PCR for Detection of Borrelia burgdorferi in Skin Biopsy and Urine Samples from Patients with Skin Borreliosis." Journal of Clinical Microbiology 36, no. 9 (1998): 2658–65. http://dx.doi.org/10.1128/jcm.36.9.2658-2665.1998.

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Skin biopsies of 36 patients with erythema migrans and acrodermatitis chronica atrophicans (ACA) before therapy and those of 8 patients after therapy were examined for Borrelia burgdorferi DNA by PCR. Skin biopsies of 27 patients with dermatological diseases other than Lyme borreliosis and those of 10 healthy persons were examined as controls. Two different primer sets targeting 23S rRNA (PCR I) and 66-kDa protein (PCR II) genes were used. PCR was performed with freshly frozen tissue (FFT) and paraffin-embedded tissue (PET). For FFT specimens of erythema migrans, 73% were positive by PCR I, 79% were positive by PCR II, and 88% were positive by combining PCR I and II. For PET specimens, PCR was less sensitive (PCR I, 44%; PCR II, 52%). For FFT specimens of ACA, PCR I was positive for two of five patients and PCR II was positive for four of five patients. B. burgdorferi was cultured from 79% of the erythema migrans specimens but not from any of the ACA lesions. Elevated B. burgdorferi antibodies were detected in sera of 74% of erythema migrans patients and 100% of ACA patients. All urine samples were negative by PCR II, whereas PCR I was positive for 27%. However, hybridization of these amplicons was negative. Sequencing of three amplicons identified nonborrelial DNA. In conclusion, urine PCR is not suitable for the diagnosis of skin borreliosis. A combination of two different primer sets achieves high sensitivity with skin biopsies. In early erythema migrans infection, culture and PCR are more sensitive than serology.
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47

Wormser, Gary P., John Nowakowski, Robert B. Nadelman, Susan Bittker, Denise Cooper, and Charles Pavia. "Improving the Yield of Blood Cultures for Patients with Early Lyme Disease." Journal of Clinical Microbiology 36, no. 1 (1998): 296–98. http://dx.doi.org/10.1128/jcm.36.1.296-298.1998.

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This study was designed to improve the recovery of Borrelia burgdorferi from blood. With the techniques used, B. burgdorferi could be recovered from the blood of approximately 25% of patients with early Lyme disease associated with erythema migrans. Serum was a better source of culture material than whole blood. The volume of blood cultured correlated directly with yield, particularly for patients with a single erythema migrans lesion.
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48

D, Banik. "Erythema Migrans: Diagnostic Clue or Criteria for Lyme disease?" International Journal of Case Reports and Clinical Images 2, no. 1 (2020): 1–2. http://dx.doi.org/10.36266/ijcrci/116.

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49

Koçinaj, Allma, Antigona Gërçari, Mybera Ferizi, Edlira Lashi, Lorela Gjunkshi, and Monika Fida. "Multiple Erythema Lesions Obscured As Fungal Skin Infection." Open Access Macedonian Journal of Medical Sciences 2, no. 3 (2014): 472–73. http://dx.doi.org/10.3889/oamjms.2014.083.

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Erythema migrans is a ring like erythema, with a few centimeters in diameter. Usually it occur solitary, days to weeks after an infected tick bite. According to skin changes it can be manifested acutely such as erythema migrans in Lyme Borreliosis, borrelial lymphocytoma (subacute), or as a late Lyme disease with acrodermatitis chronica atrophicans. All stages of this disease can be treatable with antimicrobial agents. As a first case in our department with multiple lesions, we describe a 14-year-old female and review the patient’s clinical and laboratory features, the causes of the disease, diagnosis as well as treatment.
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50

TOHGI, Kimiko, Kumiko SUGIHARA, and Joji JIDOI. "Two cases of erythema chronicum migrans." Nishi Nihon Hifuka 49, no. 1 (1987): 45–49. http://dx.doi.org/10.2336/nishinihonhifu.49.45.

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