Erythema migrans chronic Afzelius-Lipschutz: causes, symptoms, diagnosis, treatment

Erythema migratory chronic Afletsius-Lipshutts (syn. Erythema anulare chronicum migrans) - manifestation of the first stage of borreliosis - an infectious disease caused by a spirochete of the genus Borrelia, transmitted by tick bites. Clinically manifested by the development of a tick bite at the site of a reddish-cyanotic stain slightly elevated above the skin. Due to peripheral growth, the focus can take round, oval or polycyclic outlines and reach a gigantic size, with the central part regressing, the periphery retains the erythematous rim. During the period of progression, the peripheral rim does not cease. In the center on the site of the bite, the hemorrhagic or pigmented point is retained for a long time. A foci without treatment exists for several weeks or months, then other signs of borreliosis develop: lymphocytoma, idiopathic progressive skin atrophy. In addition to skin changes, there may be malaise, muscle pain, lymphadenopathy, fever, arthralgia, cardiovascular, neurological and other symptoms.

Pathomorphology of the erythema of migratory chronic Aflicius-Lipshutts. In the acute stage of the inflammatory process, hemorrhagic crust is present on the surface of the affected epidermis, and in the malpighian layer - exocytosis of erythrocytes and eosinophilic granulocytes. In the dermis - pronounced edema and perivascular infiltrates from eosinophilic granulocytes, lymphocytes and a small number of tissue basophils. In the subacute stage, the epidermis is unremarkable only in places, but in places it is somewhat thickened, in the middle and lower parts of the dermis - mainly a perivascular infiltrate consisting of lymphocytes surrounded by neutrophilic and eosinophilic granulocytes and mononuclear elements located in its central part, resulting in a histological pattern resembling lymphatic follicles. In the chronic stage the epidermis is thickened, in the dermis - fibrosis. At the same time, you can find giant cells of foreign bodies, small infiltrates from lymphocytes and eosinophils with a large admixture of tissue basophils.