Borrelious lymphocytoma as rare manifestation of Lyme disease

Abstract

In recent years, an increase in the incidence of Lyme borreliosis (Lyme disease (LD)) has been noted in the world, which causes the need for constant epidemic and clinical alertness. The causative agent of LD is Borrelia burgdorferi spirochete, transmitting agents are Ixodes ricinus mites. Migratory erythema appears at the site of mite suction, which is a marker of cutaneous manifestation of LD — an early localized (І) stage of the disease. In the presence of migratory erythema, the diagnosis of Lyme borreliosis is not difficult, but in the absence of the information about tick inoculation, the diagnosis is difficult. Timely detection and treatment of LD is important to prevent chronic disease, its progression with multiorgan lesions and complications, one of which is Borrelious lymphocytoma which refers to pathognomonic cutaneous manifestations of LD as a sign of dissemination (II or III) stage.Borreliosis lymphocytoma is diagnosed by positive serological tests — detection of antibodies to B. burgdorferi. The localization of borreliosis lymphocytoma — ear lobes, areolas of the nipples of the mammary glands, axillary cavities, occiput, scrotum, rear feet — is of decisive importance for the diagnosis. Treatment of both migratory erythema and borreliosis lymphocytoma consists of antibiotics. A rare case of borreliosis lymphocytoma is described in a patient with the disease duration of more than 15 years with the localization of the pathological process on the skin of the left ear in the area of the lobe and around it. The treatment plan was drawn up in two directions: the first included antibiotics and a synthetic drug that inhibited the activity of T lymphocytes without affecting B lymphocytes; the second one included pathogenetic drugs that increase the production of antibodies, reduce the manifestations of secondary immunodeficiency and have an anti-inflammatory effect. The pictures of the patient in dynamics are presented as she recovers. After the therapy, the patient achieved clinical recovery.