59. Lyme Borreliosis

  1. Alan D. Irvine MD, FRCPI, FRCP2,3,
  2. Peter H. Hoeger MD4,5 and
  3. Albert C. Yan MD, FAAP, FAAD6,7
  1. Susan O'Connell LRCP&SI, DipClinMicro

Published Online: 24 MAY 2011

DOI: 10.1002/9781444345384.ch59

Harper's Textbook of Pediatric Dermatology, Volume 1, 2, Third Edition

Harper's Textbook of Pediatric Dermatology, Volume 1, 2, Third Edition

How to Cite

O'Connell, S. (2011) Lyme Borreliosis, in Harper's Textbook of Pediatric Dermatology, Volume 1, 2, Third Edition (eds A. D. Irvine, P. H. Hoeger and A. C. Yan), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444345384.ch59

Editor Information

  1. 2

    Trinity College, Dublin, Ireland

  2. 3

    Our Lady's Children's Hospital, Dublin, Ireland

  3. 4

    University of Hamburg, Hamburg, Germany

  4. 5

    Catholic Children's Hospital Wilhelmstift, Hamburg, Germany

  5. 6

    University of Pennsylvania School of Medicine, Philadelphia, PA, USA

  6. 7

    The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Author Information

  1. Lyme Borreliosis Unit, Health Protection Microbiology Laboratory, Southampton University Hospitals NHS Trust, Southampton, UK

Publication History

  1. Published Online: 24 MAY 2011
  2. Published Print: 3 JUN 2011

ISBN Information

Print ISBN: 9781405176958

Online ISBN: 9781444345384



  • acrodermatitis chronica atrophicans;
  • Bannwarth syndrome;
  • Borrelia burgdorferi;
  • borrelial lymphocytoma;
  • erythema (chronicum) migrans;
  • facial palsy;
  • Lyme arthritis;
  • neuroborreliosis;
  • post-Lyme syndrome


Lyme borreliosis is the most common vectorborne infection in the temperate northern hemisphere. It is caused by Borrelia burgdorferi, a spirochaete transmitted by ixodid (hard-bodied) ticks. About 90% of patients with symptomatic infection have erythema migrans, a rash spreading slowly from the site of a tick bite, which responds well to antibiotic treatment. Multiple patches of erythema migrans can occur following bloodstream spread, and are usually accompanied by other systemic manifestations. Other uncommon skin presentations include borrelial lymphocytoma and acrodermatitis chronica atrophicans. Neurological complications include facial palsy, lymphocytic meningitis, radiculopathy and rarely encephalomyelitis. Musculoekeletal presentations include myalgias and arthralgias in the early stages and some untreated patients may develop large joint arthritis with marked synovitis, usually affecting the knee. The infection is treatable with antibiotics at any stage and the outcome is generally good, but the degree of recovery from very long-standing active infection will depend on the severity of tissue damage sustained prior to treatment.