Recognition and Treatment of Erythema Migrans: Are We Off Target?
Authors: Robert B. Nadelman, Gary P. Wormser
Journal: Annals of Internal Medicine (2002)

Editorials19 March 2002Recognition and Treatment of Erythema Migrans: Are We Off Target?Robert B. Nadelman, MD and Gary P. Wormser, MDRobert B. Nadelman, MDDrs. Nadelman and Wormser: New York Medical College; Lyme Disease Diagnostic Center of Westchester Medical Center and Gary P. Wormser, MDDrs. Nadelman and Wormser: New York Medical College; Lyme Disease Diagnostic Center of Westchester Medical CenterAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-136-6-200203190-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The clinical manifestation most closely associated with Lyme disease is the rash that develops at the site of a bite from an Ixodes scapularis tick. Erythema migrans is present in at least 90% of objective cases of Lyme disease (1). Although it usually resolves spontaneously (that is, without any antimicrobial therapy), it may be the forerunner, in untreated patients, of cardiac, neurologic, or arthritic conditions, causing significant morbidity (1, 2). These sequelae generally respond to antibiotics (1-3). However, treatment of patients with erythema migrans is usually highly effective in preventing the development of these complications (1-3).Despite the importance of ...References1. Nadelman RB, Wormser GP. Lyme borreliosis. Lancet. 1998;352:557-65. [PMID: 9716075] CrossrefMedlineGoogle Scholar2. Steere AC. Lyme disease. N Engl J Med. 2001;345:115-25. [PMID: 11450660] CrossrefMedlineGoogle Scholar3. Wormser GP, Nadelman RB, Dattwyler RJ, Dennis DT, Shapiro ED, Steere AC, et al . Practice guidelines for the treatment of Lyme disease. The Infectious Diseases Society of America. Clin Infect Dis. 2000;31 Suppl 1 1-14. [PMID: 10982743] CrossrefMedlineGoogle Scholar4. Nadelman RB, Wormser GP. 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Nadelman and Wormser: New York Medical College; Lyme Disease Diagnostic Center of Westchester Medical CenterDisclaimer: The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the New York State Department of Health.Grant Support: In part by the Tick-borne Diseases Institute of the New York State Department of Health (C-015088).Corresponding Author: Robert B. Nadelman, MD, New York Medical College, Division of Infectious Diseases, Munger Pavilion, Second Floor, Valhalla, NY 10595.Current Author Addresses: Drs. Nadelman and Wormser: New York Medical College, Division of Infectious Diseases, Munger Pavilion, Second Floor, Valhalla, NY 10595. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinical Characteristics and Treatment Outcome of Early Lyme Disease in Patients with Microbiologically Confirmed Erythema Migrans Robert P. Smith , Robert T. Schoen , Daniel W. Rahn , Vijay K. Sikand , John Nowakowski , Dennis L. Parenti , Mary S. Holman , David H. Persing , and Allen C. Steere Metrics Cited byThe presenting characteristics of erythema migrans vary by age, sex, duration, and body locationEfficacy and Safety of Antibiotic Therapy in Early Cutaneous Lyme BorreliosisEfficacy and safety of pharmacological agents in the treatment of erythema migrans in early Lyme borreliosis—systematic review protocolErythema MigransAtypical Erythema Migrans in Patients with PCR-Positive Lyme DiseaseBull's-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema MigransLyme diseaseErythema MigransBorréliose de LymeBorreliosis de LymeLyme borreliosis in Europe and North America 19 March 2002Volume 136, Issue 6Page: 477-479KeywordsAntibioticsDoxycyclineErythemaInfectious diseasesLyme diseaseRashesResearch laboratoriesSafety studiesTicksVaccines ePublished: 19 March 2002 Issue Published: 19 March 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...