Erythema Migrans - Causes and Signs of Erythema Migrans

The disease is classified depending on its progression and has the following stages:

• First stage. Occurs after an insect bite, manifested by slight swelling and redness of the bite site. The size of the lesion is small (up to 5 cm).
• Second stage. Characterized by an expansion of the diameter of the spot (15 cm or more), the central part of the lesion is weakly pigmented, fibrosis of the dermis occurs.

• The third stage can have two options: recovery and complication. During recovery, the disease goes away completely, but if complicated, the central nervous system may be affected.

Causes

The main cause of the disease is a tick bite followed by infection with the spirochete Borrellia burgdorferi.

Also a predisposing factor for the development of the disease is the risk of transmission of the disease from a sick mother to a child.

Symptoms

The main symptoms of the disease are:

• the appearance of an inflamed round spot at the site of the bite;
• the spot gradually increases in size and can reach a diameter of 15-20 cm;
• as the spot expands, its central part is weakly pigmented, has a pale red shade;
• the most common places for the spot to be localized are the armpits, back, popliteal areas, buttocks;
• if the bite site fell on delicate areas of the skin, then a burning, itching, tingling sensation is possible;
• rarely, there is a deterioration in general health;
• in severe cases, the causative agent of the disease, the spirochete Borrellia burgdorferi, can cause a disease of the central nervous system, most often meningitis.

If you have the above symptoms after an insect bite, you need to make an appointment with a dermatologist.

Diagnostics

Diagnostics of the disease is carried out by a dermatologist or an infectious disease specialist.

The main diagnostic methods for migratory erythema:

• objective examination of the patient, collection of anamnesis (especially important is the patient's previous stay in forest areas and in nature);
• serological examination of blood serum, synovial and cerebrospinal fluid in order to detect antibodies of the pathogen;
• histological examination makes it possible to make an accurate diagnosis;
• consultation with a neurologist if complications of the disease from the central nervous system appear;

An important role is also given to differential diagnostics of the disease. Migratory erythema should be distinguished from other insect bites, annular erythema Darier and linear migratory myiasis.

Treatment

The main treatment for migratory erythema is antibiotic therapy.

Other treatments are also used in parallel:

• antibacterial and glucocorticosteroid ointments for external use;
• vitamin therapy;
• limiting exposure to sunlight or cold temperatures;
• immune therapy;
• anti-tick gamma globulin;
• elimination of bad habits.

Prevention

Specific prevention of erythema migrans has not been developed to date. The basis of prevention in this case is maximum protection of the body when visiting forests. Prevention includes:

• clothes with high collars and long sleeves;
• long trousers;
• gloves, hat;
• closed shoes;
• use of special chemical protective equipment.

If you find a tick on your body that has already managed to bite into the skin, then the skin must be treated with an antiseptic and then remove the tick with light twisting movements.

In no case should you pull out a tick vertically, since there is a high risk that the head and proboscis of the tick will remain inside the skin.

After returning from walks in nature, it is necessary to very carefully examine the skin for ticks, it is better to examine the scalp under a lamp with a bright light.

If you have been bitten by a tick and inflammation has appeared at the site of the bite, which is gradually increasing in size, you need to consult a dermatologist.