Erythema Chronicum Migrans

A deep type of gyrate erythema that follows a bite by an ixodid tick; it is a stage-1 manifestation of LYME DISEASE. The site of the bite is characterized by a red papule that expands peripherally as a nonscaling, palpable band that clears centrally. This condition is often associated with systemic symptoms such as chills, fever, headache, malaise, nausea, vomiting, fatigue, backache, and stiff neck.

Networked: 53 relevant articles (3 outcomes, 2 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Lyme Disease (Disease, Lyme)
2.	Meningitis
3.	Reactive Arthritis (Reiter Disease)
4.	Localized Scleroderma (Morphea)
5.	Arthritis (Polyarthritis)

Experts

1.	Atiq, Nasirah: 1 article (01/2013)
2.	van Meurs, Tim: 1 article (01/2013)
3.	Kuznetsov, Alexander Vasilevic: 1 article (10/2011)
4.	Weisenseel, Peter: 1 article (10/2011)
5.	Prinz, Joerg Christoph: 1 article (10/2011)
6.	Flaig, Michael Josef: 1 article (10/2011)
7.	Ruzicka, Thomas: 1 article (10/2011)
8.	Bhate, Chinmoy: 1 article (04/2011)
9.	Schwartz, Robert A: 1 article (04/2011)
10.	Gaspari, Valeria: 1 article (03/2008)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Erythema Chronicum Migrans:

1.	Penicillins (Penicillin)FDA Link 07/01/1958 - "Part B: penicillin therapy; lymphadenosis benigna cutis & erythema chronicum migrans, connections & etiology; summary]." 11/01/1989 - "Furthermore, two cases of erythema chronicum migrans, which is considered pathognomonic for Borrelia infection, were treated with penicillin perorally. " 07/01/1980 - "Although the clinical manifestations of the disease may fluctuate in frequency from year to year and influence apparent antibiotic effect, we conclude that penicillin therapy shortens the duration of erythema chronicum migrans and may prevent or attenuate subsequent arthritis." 01/01/1985 - "The antibody response to one of the spirochetal strains isolated from Swedish I. ricinus was studied in 37 patients with the typical clinical picture of erythema chronicum migrans (ECM), in 45 patients with chronic meningitis (CMe) cured by high-dose intravenous penicillin, in 298 patients with post-infectious arthritis, and in controls. " 03/01/1991 - "The skin diseases Erythema (chronicum) migrans (ECM, EM), Lymphadenosis benigna cutis (LABC), and Acrodermatitis chronica atrophicans (ACA) have long been described in northern Europe, and dermatologists are very familiar with these manifestations, which have been successfully treated with penicillin for about 40 years without the causative agent being known. "
2.	AntigensIBA 01/01/1981 - "Serological study with rickettsial antigens in erythema chronicum migrans." 10/01/2000 - "To determine whether antigen-presenting Langerhans cells (LCs), which reportedly show signs of injury in erythema chronicum migrans (ECM), the early stage of disease, are altered in ACA. " 04/01/1990 - "The diagnosis was confirmed serologically by the finding of increased levels of antiborrelial antibodies assessed by the ELISA method, using antigen from Borrelia recurrentis, in a total of 87% patients with erythema chronicum migrans and in all patients with lymphadenosis benigna cutis. " 01/01/1981 - "21 sera of 13 patients with erythema chronicum migrans (ECM) and related diseases were examined for the presence of antibodies against 14 rickettsial antigens by using 3 serological techniques in 2 laboratories. " 08/01/1995 - "One hundred patients, aged 6-15 years and presented to El-Shatby University Children's Hospital with chronic/recurrent arthritis and skin lesions suggestive of erythema chronicum migrans (ECM), were investigated for presence of IgG antibodies against Borrelia burgdorferi flagellum antigen ELISA test. "
3.	Anti-Bacterial Agents (Antibiotics)IBA 01/20/1984 - "Of 39 patients with erythema chronicum migrans mostly treated with antibiotics 50% had increased IgG antibody titre (1:64 to 1:1024) against the isolated spirochete, while among 51 untreated patients with tick-transmitted meningopolyneuritis 90% had increased IgG antibody titres. " 04/04/1985 - "As compared with nonresponders, penicillin-responsive patients in both studies were more likely to have previously received antibiotics for erythema chronicum migrans (P less than 0.02) and less likely to have been given intraarticular corticosteroids during or at the conclusion of parenteral therapy (P less than 0.1). "
4.	Adrenal Cortex Hormones (Corticosteroids)IBA 04/04/1985 - "As compared with nonresponders, penicillin-responsive patients in both studies were more likely to have previously received antibiotics for erythema chronicum migrans (P less than 0.02) and less likely to have been given intraarticular corticosteroids during or at the conclusion of parenteral therapy (P less than 0.1). "
5.	AntibodiesIBA 01/01/1986 - "26 Swedish patients with erythema chronicum migrans (ECM) were studied regarding associated clinical symptoms and antibodies to Swedish Ixodes ricinus spirochete. " 01/01/1986 - "Erythema chronicum migrans in Sweden: clinical manifestations and antibodies to Ixodes ricinus spirochete measured by indirect immunofluorescence and enzyme-linked immunosorbent assay." 04/15/1983 - "Antibodies against Borrelia duttoni using indirect immunofluorescence could be demonstrated in 6 patients with erythema chronicum migrans and in 8 persons with tick-borne meningopolyneuritis. " 07/01/1994 - "For two children with facial palsy following erythema chronicum migrans, neither IFA nor capture ELISA detected specific intrathecal antibodies and PCR was also negative. " 03/01/1994 - "Early diagnosis of Borrelia burgdorferi infection, hampered by the absence of detectable antibodies in most patients with erythema chronicum migrans is important to prevent late-stage neurologic, rheumatologic, and skin disorders. "
6.	Tetracycline (Achromycin)FDA LinkGeneric 04/01/1987 - "All 5 patients had been treated for erythema chronicum migrans with a course of tetracycline that met or exceeded current recommendations. " 07/01/1980 - "Erythema chronicum migrans and its associated symptoms resolved faster in patients given penicillin or tetracycline (median duration, 4 and 2 days, respectively) than in untreated patients (10 days; P less than 0.001 and P = 0.005, respectively). " 09/01/1986 - "Although the preferred antibiotic for treating erythema chronicum migrans of Lyme disease has not been conclusively established, tetracycline and penicillin proved effective. " 06/01/1983 - "Physicians in areas where Lyme disease has traditionally not been recognized should be alerted to its characteristic rash (erythema chronicum migrans), tick vector (Ixodes species), possible severe manifestations (neurologic, arthritic, and cardiac), and response to appropriate antibiotic therapy (penicillin or tetracycline)." 07/01/1983 - "Erythema chronicum migrans and its associated symptoms resolved faster in penicillin- or tetracycline-treated patients than in those given erythromycin (mean duration, 5.4 and 5.7 versus 9.2 days, F = 3.38, p less than 0.05). "
7.	Immunoglobulin G (IgG)IBA 01/20/1984 - "Of 39 patients with erythema chronicum migrans mostly treated with antibiotics 50% had increased IgG antibody titre (1:64 to 1:1024) against the isolated spirochete, while among 51 untreated patients with tick-transmitted meningopolyneuritis 90% had increased IgG antibody titres. " 02/01/1987 - "In order to prove the etiology of manifestations of erythema chronicum migrans disease of the nervous system like meningopolyneuritis Garin-Bujadoux-Bannwarth or progressive borrelia encephalomyelitis we used the ELISA to measure specific IgG antibodies against Ixodes ricinus borrelia per microgram IgG in serum and cerebrospinal fluid. " 01/06/1984 - "Using indirect immunofluorescence, IgG antibodies against the recently detected Ixodes-ricinus-spirochaeta, which causes erythema chronicum migrans could be demonstrated in all 21 persons with acrodermatitis chronica atrophicans. " 08/01/1995 - "One hundred patients, aged 6-15 years and presented to El-Shatby University Children's Hospital with chronic/recurrent arthritis and skin lesions suggestive of erythema chronicum migrans (ECM), were investigated for presence of IgG antibodies against Borrelia burgdorferi flagellum antigen ELISA test. " 01/06/1984 - "Fourfold decreases could be found only once for each IgG and IgM antibodies.l Serology indicates that acrodermatitis chronica atrophicans as well as erythema chronicum migrans is caused by the Ixodes-ricinus-spirocheta."
8.	Immunoglobulin M (IgM)IBA 08/01/1987 - "Levels of IgM-RF greater than 3 SD above the mean of normal subjects were found in 2 of 15 patients with erythema chronicum migrans, 7 of 10 with neurologic abnormalities, and 7 of 25 with Lyme arthritis (p = 0.038). " 07/01/1980 - "Heart involvement was usually preceded by erythema chronicum migrans and sometimes accompanied by meningoencephalitis, facial palsy, arthritis, elevated serum IgM levels, or cryoglobulins containing IgM. " 01/06/1984 - "Fourfold decreases could be found only once for each IgG and IgM antibodies.l Serology indicates that acrodermatitis chronica atrophicans as well as erythema chronicum migrans is caused by the Ixodes-ricinus-spirocheta." 03/01/1994 - "Only two of the erythema chronicum migrans patients had IgG or IgM antibodies to flagellin. "
9.	DNA (Deoxyribonucleic Acid)IBA 10/01/1995 - "burgdorferi DNA and lesional erythema chronicum migrans tissues, which were used as positive controls, yielded easily detectable products with all primer sets. " 10/01/1993 - "Using this technique, Bb-specific DNA was clearly identified in 8 of 12 specimens of erythema chronicum migrans and in 1 case of lymphadenosis benigna cutis. " 03/01/1994 - "Successful amplification of DNA specific for Finnish Borrelia burgdorferi isolates in erythema chronicum migrans but not in circumscribed scleroderma lesions." 03/01/1994 - "burgdorferi outer surface protein OspA-specific sequences in DNA obtained from lesional skin biopsies on Finnish patients with clinically suspect erythema chronicum migrans, lymphocytoma, morphea, or with diverse skin manifestations and persistent high antibodies to B. "
10.	FlagellinIBA 12/01/1990 - "The flagellin ELISA test detected antibodies in patients with erythema chronicum migrans (ECM) more often than the other test systems. " 03/01/1994 - "Only two of the erythema chronicum migrans patients had IgG or IgM antibodies to flagellin. "

Therapies and Procedures

1.

Retreatment 01/01/1988 - "Between June 1981 and July 1987 the efficacy of antibiotic treatment of 215 patients with erythema chronicum migrans of Lyme disease was evaluated in terms of the necessity for retreatment and the prevention of the late manifestations of Lyme disease. " 09/01/1986 - "The efficacy of antibiotic treatment of 117 patients with erythema chronicum migrans of Lyme disease was evaluated in terms of the necessity for retreatment and the prevention of the late manifestations of Lyme disease. "