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Lyme Disease

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Skin and the Heart

Abstract

Lyme disease or Lyme borreliosis is a vector-borne disease caused by the Borrelia burgdorferi spirochete. It is a systemic infectious disease which may express cardiac, neurological, dermatological and rheumatological manifestations. Different clinical manifestations are related to the genetic diversity of the Borreliae, depending on geographical area.

Skin manifestations include erythema migrans, borrelial lymphocytoma and acrodermatitis chronica atrophicans. Systemic manifestations could be neurological, cardiovascular, rheumatic, opthalmologic etc.

The course of the disease could be divided into stages, but to distinguish the early and late infection is more practical. 7–14 days after the tick bite clinical signs and symptoms develop. Skin is affected in 80–90% patients, other organs in 10–20%.

At the early stage, the nervous system is mostly affected. Cardiac manifestations may be preceded by dermatological manifestations and they are related to conduction or rhythm problems.

Borrelial DNA could be detected by PCR even a few months after therapy. Cardiac evaluation should include an electrocardiogram or a 24-h Holter ECG.

Antibiotic therapy includes doxycycline, and in allergic patients, macrolides. The duration of therapy should be at least 2 weeks. Patients with extracutaneous symptoms are treated with ceftriaxone.

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Acknowledgments

All clinical pictures in this chapter are courtesy of prof. Jana Třešňák Hercogová and are part of her work Klinická dermatovenerologie, 2019, Mladá fronta, 2nd Vol—x in press already printed: Hercogová, J. Lymeská borelióza. In: Hercogová J. (ed) et al. Klinická dermatovenerologie, 2nd vol., 2019, Mladá fronta, p. 1235–1246, ISBN 987-80-204-5549-9.

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Authors and Affiliations

  1. Department of Dermatovenereology, 2nd Medical Faculty, Charles University Prague and Na Bulovce Hospital, Prague, Czech Republic

    Jana Třešňák Hercogová

  2. Department of Dermatovenereology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic

    Jana Třešňák Hercogová

  3. Department of Dermatovenereology, Prague, Czech Republic

    Jana Třešňák Hercogová

  4. Cardiology Department “Marie Curie” Emergency Children’s Hospital, Pediatrics Department “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

    Eliza Cinteza

Authors
  1. Jana Třešňák Hercogová
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  2. Eliza Cinteza
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Editor information

Editors and Affiliations

  1. Paediatric Dermatology Department, Colentina Clinical Hospital, “Carol Davila”, University of Medicine and Pharmacy, Bucharest, Romania

    Carmen Salavastru

  2. Professor of Dermatology, University of New South Wales, Sydney, NSW, Australia

    Dedee F. Murrell

  3. Department of Cardiology, Liverpool Hospital, University of New South Wales, Sydney, NSW, Australia

    James Otton

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Třešňák Hercogová, J., Cinteza, E. (2021). Lyme Disease. In: Salavastru, C., Murrell, D.F., Otton, J. (eds) Skin and the Heart. Springer, Cham. https://doi.org/10.1007/978-3-030-54779-0_14

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  • DOI: https://doi.org/10.1007/978-3-030-54779-0_14

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  • Online ISBN: 978-3-030-54779-0

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