The more unusual symptoms a patient has, the more likely a doctor should be to consider the possibility of Lyme borreliosis.
Lyme borreliosis can cause a number of skin symptoms that also occur in other chronic infections: ranging from hives to localised systemic vasculitis and eczema – Dr Klára Esztó, a dermatologist, clinical allergist and immunologist who has been treating patients with symptoms of Lyme disease for 45 years.
Hives are a common dermatological condition, characterised by the appearance of itchy skin lesions of varying sizes, which are slightly raised, all over the body. Systemic vasculitis is a collective term. In such cases, the organ affected by the inflammation may be damaged, and the lesion can develop in any part of the body. A distinction can be made between primary and secondary vasculitis; the latter may also develop as a result of viral or bacterial infections. Eczema is also one of the better-known skin conditions; it is characterised by flaking, blisters, swelling, redness, oozing, crusting, etc., accompanied by unpleasant itching. In addition to these, Lyme borreliosis can also cause lesser-known skin conditions, which typically can only be diagnosed by specialist dermatologists.
The skin conditions mentioned above are among the rarer, non-specific symptoms of Lyme borreliosis. The typical symptom is redness at the site of the bite: the Lyme rash or erythema migrans, which, although a clear sign of Lyme disease, does not rule out the presence of the infection if it is absent. The Lyme rash later spreads concentrically across the skin, whilst the centre of the lesion becomes increasingly paler – points out Dr Klára Esztó. Another characteristic skin symptom of Lyme infection, particularly in children, is a red lump that usually appears on the ear or nipple and is not accompanied by any symptoms. The condition is called lymphocytoma. A third specific skin symptom indicates long-standing Lyme disease: it occurs on the hands and feet; its Latin name is acrodermatitis chronica, and it is characterised by the skin becoming thin and wrinkled due to the destruction of fibres within it, taking on a parchment-like thinness.
Even in the case of non-specific symptoms, or where a combination of various symptoms is present, it is important for doctors to suspect Lyme disease, even if their clinical experience initially suggests a psychosomatic cause.
“It is important to consider Lyme borreliosis!” advises the Lyme disease specialist. Internet search engines can also help our patients in this regard: fortunately, there are now an increasing number of reliable specialist websites where the symptoms of Lyme disease are described accurately and in detail: anyone who feels tired, suffers from headaches, has joint pain, numbness, sensory disturbances or nerve pain, eyelid twitching, or difficulty remembering things, and type all these symptoms into a search engine, they will almost certainly find Lyme borreliosis. Dr Klára Esztó told Weborvos that she had many patients in her practice who realised in this way that they might have been infected by a tick. Despite all this, it is very important that patients do not suspect they have Lyme borreliosis on their own – however reputable the website may be – but that their GP investigates this possibility at an early stage of the illness.
We also recommend this to fellow doctors: those who have rarely encountered Lyme disease among their patients should consult reliable online professional sources to recognise the symptoms of the disease as accurately as possible.
According to a Lyme disease specialist, symptoms that appear unrelated are often like pieces of a jigsaw puzzle. If we put them together correctly, the result becomes clear: the patient has Lyme borreliosis. The more unusual symptoms a patient has, the more a doctor should consider this condition! – advises Dr Klára Esztó.
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