Clinical spectrum of skin manifestations of Lyme borreliosis in 204 children in Austria.

Abstract

The spectrum of skin manifestations of Lyme borreliosis in children is not well characterized. We conducted a retrospective study to analyze the clinical characteristics, seroreactivity to Borrelia burgdorferi sensu lato, and outcome after treatment in 204 children with skin manifestations of Lyme borreliosis seen in 1996-2011. Solitary erythema migrans was the most common manifestation (44.6%), followed by erythema migrans with multiple lesions (27%), borrelial lymphocytoma (21.6%), and acrodermatitis chronica atrophicans (0.9%). A collision lesion of a primary borrelial lymphocytoma and a surrounding secondary erythema migrans was diagnosed in 5.9% of children. Rate of seroreactivity to B. burgdorferi s.l. was lower in solitary erythema migrans compared to other diagnosis groups. Amoxicillin or phenoxymethylpenicillin led to complete resolution of erythema migrans within a median of 6 (solitary) and 14 days (multiple lesions), respectively, and of borrelia lymphocytoma within a median of 56 days. In conclusion, erythema migrans with multiple lesions and borrelial lymphocytoma appear to be more frequent in children than in adults, whereas acrodermatitis chronica atrophicans is a rarity in childhood. The outcome after antibiotic therapy was excellent in children, and appears to be better than in adults.

• Authors: Martin Glatz, Astrid Resinger, Kristina Semmelweis, Christina M Ambros-Rudolph, Robert R Müllegger
• Journal: Acta dermato-venereologica (Acta Derm Venereol) Vol. 95 Issue 5 Pg. 565-71 (May 2015) ISSN: 1651-2057 [Electronic] Sweden
• PMID: 25366035 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Acrodermatitis (drug therapy, etiology, physiopathology)
• Administration, Oral
• Adolescent
• Anti-Bacterial Agents (administration & dosage)
• Borrelia burgdorferi (isolation & purification)
• Child
• Child, Preschool
• Cohort Studies
• Drug Therapy, Combination
• Erythema Chronicum Migrans (drug therapy, etiology, physiopathology)
• Female
• Follow-Up Studies
• Humans
• Injections, Intravenous
• Lyme Disease (complications, diagnosis, drug therapy)
• Male
• Pseudolymphoma (drug therapy, etiology, physiopathology)
• Retrospective Studies
• Risk Assessment
• Severity of Illness Index
• Treatment Outcome