CASE 64

Erythema migrans

QUESTION 64

A 21-year-old otherwise healthy man presents to the dermatology clinic with an enlarging rash on the trunk. He works as a landscaper and states that no one else at work has a similar-appearing rash. The patient reports noticing the lesion on his upper trunk approximately 4 days ago when he also experienced fatigue, a low-grade fever, and chills. On examination, there are two expanding erythematous-to-violaceous plaques on the left lateral trunk with central clearing and a brightly erythematous border (64).

i. What are these lesions called, and what is the aetiology?

ii. What diagnostic tests can be performed, and what are their limitations?

iii. What is the cutaneous finding of this disease in its chronic form?

iv. What are the treatment options?

Answer 64

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