Akademik Veri Yönetim Sistemi
Turkiye Klinikleri Dermatoloji, cilt.23, sa.1, ss.21-27, 2013 (Scopus)
Lyme disease is a multysystemic infectious disease caused by spirochetes called "Borrelia burgdorferi", as a result of tick bite. Except the typical clinical lesions, a few granuloma annulare associated with borrelia infection have been reported, in recent years. In this report, presented a 52-year-old woman with generalized granuloma annulare. According to the medical history, the patient was bitten by a tick one year ago. Other clinical examination, routine hematological and biochemical investigations of patients were normal ranges and performed cutaneous biopsy was compatible with granuloma annulare. Borrelia IgM was positive and IgG was negative in the enzyme-linked immunosorbent assay (ELISA) tests, which were examined in the peripheral blood. Additionally, in the Western Immunoblotting (WB) tests for the purpose of verifying the result, borrelia IgM was positive (against specific membran vesical protein p83) and IgG was negative. Based on these findings, cutaneous lesions are thought to be associated with borrelia infection and the patient was treated with doxycycline (200 mg/day, for 14 days). No additional treatment or topical treatment were applied to the patient. Whole lesions of the patient, completely disappeared, two and half months after the initiation of treatment. The patient was presented because of any case of generalized granuloma annulare associated with borrelia infection and p83 gene have been reported in the literature previously. And, a probable crossed-mediated reaction from T-cell type which might have induced the rare type of granuloma annulare, is discussed through the concepts of "heat-shock proteins (Hsps)" and "molecular mimicry". Written informed consent was obtained from the patient for publication of this case report and any accompanying images. © 2013 by Türkiye Klinikleri.