A Case of Lyme Disease Presenting with Erychema (Chronicum) Migrans

Lyme disease (Lyme borreliosis) is a vector-borne infection primarily transmitted by Ixodes species and caused by a spirochete, Borrelia burgdorferi. This disease affects multiple areas such as skin, joints, eyes, nervous and cardiovascular systems. Erythema (chronicum) migrans, borrelial lymphocytoma and acrodermatits chronica atrophicans are the cutaneous hallmarks of Lyme disease. A 31-year-old man presented with an annular centrifugally expanding erythematous plaque with central punctum on the left scapular area for about 2 months. He was bitten by a tick 3 months ago in Kangwondo. Serologic examinations revealed increased levels of Ig M and Ig G antibodies to borrelial antigen in consecutive tests performed at an interval of three weeks. Western blot for Borrelia burgdorferi was also positive. The skin lesion showed prompt response to the tetracycline therapy and was cured after 2 weeks.