Sclerosing and granulomatous skin lesions in Borrelia burgdorferi infection

english

1996

volume 5, issue 3-4

Združenje slovenskih dermatovenerologov

The pathogenic linkage between Borrelia burgdorferi and the cutaneous manifestations of Lyme Borreliosis, i.e. erythema migrans, borrelial lymphocytoma and acrodermatitis chronica atrophicans is well established. Moreover, in three other dermatoses - carcumscribed scleroderma, lichen sclerosus et etrophicus and granuloma annulare - laboratory findings indicated that these diseases might be associated with a Borrelia burgdorferi infection. In particular, cellular or humoral immune responses to Borrelia burgdorferi, as measured by lymphocyte proliferation tests or by immunoblot investigations, respectively, were detected in some circumscribed scleroderma patients. In sporadic cases Borrelia burgdorferi was even isolated from lesional skin of patients with circumscribed scleroderma or granuloma annulare. Recently developed molecular biological techniques provide tools to detect Borrelia burgdorferi-DNA ub several tissues and body fluids. Particularly the excretion of borrelia-DNA in the urine, detected by PCR, was proven to be a useful and reliable laboratory parameter for the clinical correlation of disease activity in erythema migrans and acrodermatitis chronica atrophicans. Therefore, we investigated the excretion of Borrelia burgdorferi-DNA in the urine of patients with circumscribed scleroderma, lichen sclerosus et atrophicus and granuloma annulare by amplification of a 276 bp flegellin gene segment using a nnested PCR technique. Surprisingly, PCR was positive in 61% of patients with circumscribed scleroderma, 68% of patients with lichen scleroses et atrophicus and 61% of patients with granuloma annulare. These data provide evidence for the presence of a systemic Borrelia burgdorferi infection in a subset of patients with these dermatoses and open up a field to develop new concepts in the treatment of these patients.

16.09.2022