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Erythema Migrans - Symptoms & Treatment


Erythema migrans (EM), refers to the rash often (though not always) seen in the early stage of Lyme disease. It is found in endemic areas (clusters) all over the northern hemisphere, including the Alpe-Adria-region. Later stages of the disease don't develop until weeks or many months later. Erythema migrans can last for a few days or for more than a month a may be painless or can feel painful, itchy or hot to the touch. It may appear anywhere from 1 day to 1 month after the infected tick's bite, but it usually appears in about 7 days. The center of the rash may clear as it grows, giving it the appearance of a bull's-eye. EM affects all age groups equally and shows seasonal variations with a peak incidence between May and September, although several cases also occur regularly during the winter months. The rash will go away by itself, but since it is a sign of Lyme disease, it is an indication for antibiotic treatment. Early treatment is necessary in all cases of Lyme disease to prevent development of systemic sequelae.

The Erythema migrans rash does not represent an allergic reaction to the bite, but rather an actual skin infection with the Lyme bacteria. The only proven method of non-tick transmittal in humans is from pregnant women to their unborn children. Sometimes, the rash includes many red patches that appear in different shapes and sizes around the body. The erythema migrans type of skin rash is different from a rash that appears as an allergic reaction to a tick or insect bite. In accordance with the most frequent sites of tick bites (higher body temperature), the location of EM is usually the calf/popliteal fossa region, or the thigh/groin/buttock region, or the armpit/shoulder region. Erythema migrans in children is most frequently located in the head-neck region and often displays an atypical (band-like or gyrated) morphology. These lesions are very transient (few days) and variable in intensity over time. The lesions may be slightly scaly and have central clearing, giving them a targetlike appearance. Diagnosis can be made on the presence of erythema migrans and other symptoms, plus the evidence of a tick bite.

Causes of Erythema migrans

The common causes and risk factor's of Erythema migrans include the following:

  • The bacterium (germ), Borrelia burgdorferi.
  • Black-legged tick (deer tick) and the western black-legged tick.
  • Who has developed Lyme disease can get Erythema Migrans.
  • Spend a lot of time in the yard or grass.
  • Other associated bacterial infections include streptococcal infections (eg, bacterial meningitis).

Symptoms of Erythema migrans

Some sign and symptoms related to Erythema migrans are as follows:

  • A rash.
  • Muscle and joint aches.
  • Chills and fever.
  • Numbness and pain in arms or legs.
  • Swollen lymph nodes.
  • Chronic pain in muscles and unrestful sleep.
  • Stiff neck.
  • The rash may burn, hurt or itch.

Treatment of Erythema migrans

Here is list of the methods for treating Erythema migrans:

  • Antibiotic treatment for 3-4 weeks with doxycycline or amoxicillin is generally effective in early disease.
  • Some people may need medicine by a shot.
  • A cream or ointment may be recommended to keep the rash from getting irritated.
  • Cefuroxime axetil or erythromycin can be used for persons allergic to penicillin or who cannot take tetracyclines.

 

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