DER/THU/01 ANNULAR ERYTHEMA PRESENTING AS ERYTHEMA MIGRANS AND LYME DISEASE

C Johnson, R Murphy. Queen’s Medical Centre, Nottingham, UK

Introduction: Lyme disease is caused by the spirochaete Borrelia burgdorferi, which is transmitted by a bite from the Ixodes tick, found predominantly in woodland areas. Early treatment with doxycycline can prevent the later manifestations of this disease, which include arthritis and neuroborreliosis.

Case Report: The case of a 14-year-old girl presenting with a recurrent annular erythema who was initially misdiagnosed with Lyme disease is presented. The patient initially presented with an annular lesion on her left lower leg that had increased in size. She had been bitten at a woodland holiday resort by a tick 2 weeks previously. Examination of the legs revealed an annular erythematous lesion with central clearing suggestive of erythema migrans. A diagnosis of Lyme disease was considered and a positive titre for Borrelia IgM suggested recent exposure. She …