Borrelia Burgdorferi Seropositivity in Various Cutaneous Disorders
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BORRELIA BURGDORFERI SEROPOSITIVITY IN VARIOUS CUTANEOUS DISORDERS A.Demet KAYA*, A.Haydar PARLAK**, Aydın AYDINLI* *Okan University, Medical Faculty, Department of Medical Microbiology, Istanbul, TURKEY **Abant Izzet Baysal University, Medical Faculty, Department of Dermatology, Bolu,TURKEY Table 1: Distribution of patients due to the clinical diagnosis, age and Table 5: Distribution due to age, gender, clinical findings, RF, VDRL, Mono spot, INTRODUCTION gender ANA, IgG, IgM testing results of Western Blot confirmed patients Lyme disease, which is caused by the tick-borne Male Female Total CASE AGE GENDER CLINICAL FINDINGS RF VDRL MONOSPOT ANA IgG IgM spirochete Borrelia burgdorferi, is an important cause of Age 10-20 21-40 41 > 10-20 21-40 41 > Pitriasis rosea 8 8 6 7 12 9 50 infection in many areas of the world. Majority of lyme 1 25 F Pitriasis rosea - - - - + - borreliosis. cases display cutaneous manifestations; Chronic urticaria 2 9 2 3 8 12 36 2 49 M Linear scleroderma - - - - + - including erythema migrans, borrelial lymphocytoma and Mycosis fungoides - 1 7 - - 2 10 acrodermatitis chronica atrophicans. In light of the 3 13 F Pitriasis rosea, Arthralgia - - - - - + Others* - 1 30 1 1 32 65 increasing number of reports describing an association 4 38 M Chronic dermatidis - - - - - + between other cutaneous disorders and Borrelia Total 10 19 45 11 21 55 161 *Granuloma annulare, linear scleroderma, erythema annulare, keloid morphea, pseudolenfoma, burgdorferi, this study was planned to investigate the role pityriasis lichenoides chronica, pityriasis lichenoides et varioliformis acuta, lichen sclerosus, of Borrelia burgdorferi in the etiology of several morphea, granuloma faciale dermatosis. Table 2: ELISA testing results CONCLUSION METHODS 161 patients with pitriasis rosea, chronic Male Female IgG(+) IgM(+) IgG and IgM(+) Many cutaneous disorders, such as, morphea, lichen sclerosus et urticaria, mycosis fungoides, granuloma annulare, linear atrophicus, B cell lymphoma are also being attributed to Borrelia scleroderma, erythema annulare, keloid morphea, Age burgdorferi infection. Eosinophilic fasciitis, benign lymphocytic infiltration, pseudolymphoma, pityriasis lichenoides chronica, pityriasis 10-20 10 12 5(%22.7) - granuloma annulare, erythema multiforme, urticaria, urticarial vasculitis, lichenoides et varioliformis acuta, lichen sclerosus, 21-40 31 27 11(%19) 3(%5.2) 1(%1.7) infantile papular acrodermatitis and panniculitis have also been mentioned morphea, granuloma faciale were initially underwent in few case reports as being associated with borrelial infection.Our study 41 > 18 29 4(%8.5) 1(%2.1) physical examination and blood samples of were obtained results, with 4(2.5%) positive results out of 161 samples supports the to determine the presence of IgM and IgG antibodies. A presence of an association in our cases, but more data are needed to two-step testing strategy was used. The sera were initially Table 3: Correlation of risk factors in ELISA(+) patients clarify the role of Borrelia burgdorgferi in these dermatological conditions. tested by enzyme-linked immunosorbent assay (ELISA) In daily practice, in patients with various cutaneous disorders, Male IgG(+) IgM(+) Tick bite Animal contact Collaboration with non- and then by Western blot(WB). Demographic data specific symptoms consideration of Borrelia burgdorgferi infections in the differential regarding residence, age, sex, profession, tick-bite 10-20 1 - 1(%100) 1(%100) 1(%100) diagnosis can be useful, as skin manifestations are early features of lyme 21-40 5 3 6(%75) 5(%62.5) 7(%87.5) history, contact with animals, and symptoms concerning 41 > 2 1 2(%66.7) 2(%66.7) 3(%100) disease and identifying the cutaneous features can lead to early diagnosis Female skin, nervous system and osteoarticular system were of the disease, and help in prevention of development of further advanced collected using a questionnaire and all results were 10-20 4 1 5(%100) 4(%80) 5(%100) disease. statistically evaluated by x² test 21-40 6 - 3(%50) 4(%66.7) 6(%100) 41> 2 - 2(%100) - 2(%100) RESULTS Table 4: Western Blot Testing Results Of 161 sera of patients with dermatosis, Male IgG(+) IgM(+) 1-band 2-bands 3-bands 4-bands 5 bands Borrelia IgG and IgM positivities were 20(12.4%) and 4(2.5%), respectively. In one sera(0.6%) both IgG and 10-20 1 - - - - - 21-40 5 3 1 1 - - IgM antibodies were positive. Western Blot confirmation 41> 2 1 2 - - 1 test results yielded positivity in 4(20%) samples; 2(10%) Female IgG positive sera, 2(10%) IgM positive sera. All IgG 10-20 4 1 - 1 - - 21-40 6 - - - - 1 positive patients had tick bite, animal contact history and 41> 2 - - 1 - - 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. .