Clinical Spectrum of Skin Manifestations of Lyme Borreliosis in 204 Children in Austria

Acta Derm Venereol. 2015 May;95(5):565-71. doi: 10.2340/00015555-2000.

Abstract

The spectrum of skin manifestations of Lyme borreliosis in children is not well characterized. We conducted a retrospective study to analyze the clinical characteristics, seroreactivity to Borrelia burgdorferi sensu lato, and outcome after treatment in 204 children with skin manifestations of Lyme borreliosis seen in 1996-2011. Solitary erythema migrans was the most common manifestation (44.6%), followed by erythema migrans with multiple lesions (27%), borrelial lymphocytoma (21.6%), and acrodermatitis chronica atrophicans (0.9%). A collision lesion of a primary borrelial lymphocytoma and a surrounding secondary erythema migrans was diagnosed in 5.9% of children. Rate of seroreactivity to B. burgdorferi s.l. was lower in solitary erythema migrans compared to other diagnosis groups. Amoxicillin or phenoxymethylpenicillin led to complete resolution of erythema migrans within a median of 6 (solitary) and 14 days (multiple lesions), respectively, and of borrelia lymphocytoma within a median of 56 days. In conclusion, erythema migrans with multiple lesions and borrelial lymphocytoma appear to be more frequent in children than in adults, whereas acrodermatitis chronica atrophicans is a rarity in childhood. The outcome after antibiotic therapy was excellent in children, and appears to be better than in adults.

MeSH terms

  • Acrodermatitis / drug therapy
  • Acrodermatitis / etiology
  • Acrodermatitis / physiopathology*
  • Administration, Oral
  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Borrelia burgdorferi / isolation & purification
  • Child
  • Child, Preschool
  • Cohort Studies
  • Drug Therapy, Combination
  • Erythema Chronicum Migrans / drug therapy
  • Erythema Chronicum Migrans / etiology
  • Erythema Chronicum Migrans / physiopathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intravenous
  • Lyme Disease / complications
  • Lyme Disease / diagnosis
  • Lyme Disease / drug therapy
  • Male
  • Pseudolymphoma / drug therapy
  • Pseudolymphoma / etiology
  • Pseudolymphoma / physiopathology*
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents