Résumé
Lyme borreliosis is a multi-systemic tick-borne infectious disease caused by the spirochaete, Borrelia burgdorferi. It has many non-specific symptoms affecting the skin, eye, musculoskeletal system, cardiovascular system, and central and peripheral nervous system. Typical cutaneous manifestations of lyme borreliosis include erythema chronicum migrans, borrelia lymphocytoma appearing a few weeks after the tick bite, and acrodermatitis chronica atrophicans developing a few years after. The diagnosis is based on clinical findings with detection of specific Ig M and Ig G antibodies to Borrelia burgdorferi. A 50-year old woman presented with an erythematous to violaceous annular patch with central scaly hyperpigmented patch on the right arm and an erythematous indurated patch on the right thigh for a month. She did not recall a deer tick bite. She had severe arthralgia on the right shoulder and myalgia on the right thigh at the first visit. Three months later, she complained of chest pain, and mild dyspnea on exertions. Serologic examinations revealed increased levels of Ig M and Ig G antibodies to borrelial antigen via ELISA, and Western blot test for Borrelia burgdorferi was positive. Her general symptoms as well as skin lesions subsided with an antibiotics (Doxycycline) and steroid therapy over 4 weeks.