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P1448 Paper Poster Session Lyme Disease Borrelia Burgdorferi

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P1448 Paper Poster Session Lyme Disease Borrelia Burgdorferi P1448 Paper Poster Session Lyme disease Borrelia burgdorferi seropositivity in various cutaneous disorders Ayse Demet Kaya*1, Ali Haydar Parlak2, Aydın Aydınlı3 1Okan University Medical Faculty,Department of Medical Microbiology, Istanbul, Turkey 2Abant İzzet Baysal University Medical Faculty, Department of Dermatology, Bolu, Turkey 3Okan University Medical Faculty, Department of Medical Microbiology, Istanbul, Turkey Background: Lyme disease, which is caused by the tick-borne spirochete Borrelia burgdorferi, is an important cause of infection in many areas of the world. Majority of lyme borreliosis cases display cutaneous manifestations; including erythema migrans, borrelial lymphocytoma and acrodermatitis chronica atrophicans. In light of the increasing number of reports describing an association between other cutaneous disorders and Borrelia burgdorferi, this study was planned to investigate the role of Borrelia burgdorferi in the etiology of several dermatosis. Material/methods: 161 patients with pitriasis rosea, chronic urticaria, mycosis fungoides, granuloma annulare, linear scleroderma, erythema annulare, keloid morphea, pseudolymphoma, pityriasis lichenoides chronica, pityriasis lichenoides et varioliformis acuta, lichen sclerosus, morphea, granuloma faciale were initially underwent physical examination and blood samples of were obtained to determine the presence of IgM and IgG antibodies. A two-step testing strategy was used. The sera were initially tested by enzyme-linked immunosorbent assay(ELISA) and then by Western blot(WB). Demographic data regarding residence, age, sex, profession, tick-bite history, contact with animals, and symptoms concerning skin, nervous system and osteoarticular system were collected using a questionnaire and all results were statistically evaluated by x² test. Results: Of 161 sera of patients with dermatosis, Borrelia IgG and IgM positivities were 20 (12.4%) and 4 (2.5%), respectively. In one sera (0.6%) both IgG and IgM antibodies were positive. Western Blot confirmation test results yielded positivity in 4 (20%) samples; 2 (10%) IgG positive sera, 2 (10%) IgM positive sera. All IgG positive patients had tick bite, animal contact history and had muscle and joint pain, neurological, cardiac, dermatological and psychiatric complaints. Seropositivity was higher in the 21-40 age group and no change was observed by gender in both groups. Conclusions: Other than the three classical skin manifestations, many cutaneous disorders, such as, morphea, lichen sclerosus et atrophicus, B cell lymphoma are also being attributed to Borrelia burgdorferi infection. Eosinophilic fasciitis, benign lymphocytic infiltration, granuloma annulare, erythema multiforme, urticaria, urticarial vasculitis, infantile papular acrodermatitis and panniculitis have also been mentioned in few case reports as being associated with borrelial infection. Our study results, with 4 (2.5%) positive results out of 161 samples supports the presence of an association in our cases, but more data are needed to clarify the role of Borrelia burgdorgferi in these dermatological conditions. In daily practice, in patients with various cutaneous disorders, consideration of Borrelia burgdorgferi infections in the differential diagnosis can be useful, as skin manifestations are early features of lyme disease and identifying the cutaneous features can lead to early diagnosis of the disease, and help in prevention of development of further advanced disease. .
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