Lyme Disease

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A 34-year-old man experienced feverand arthralgia several days afterappearance of the rash shown here(A). He did not recall being bittenby a tick, as is often the case withpersons who contract Lyme disease.

A 34-year-old man experienced feverand arthralgia several days afterappearance of the rash shown here(A). He did not recall being bittenby a tick, as is often the case withpersons who contract Lyme disease.The characteristic rash of Lymedisease, erythema migrans--an annularred eruption with a centralclear area, such as the lesion shownhere on the back of a 71-year-oldwoman (B)--is observed in 70% ormore of patients. Variations includean ecchymosis-like rash, such as theone shown in A; vesicles; and diffuseerythema.

(Case and photograph A courtesy of Steven Luger, MD;photograph B courtesy of Randall H. Suslick, MD.)

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