Description
The erythema migrans rash is classically 5 to 6.8 cm in diameter, appearing as an annular homogenous erythema (59%), central erythema (30%), central clearing (9%), or central purpura (2%). Because of the "bullseye" description to describe the Lyme disease rash, the condition commonly called ringworm is sometimes confused with Lyme disease. Uncommonly, EM may be less than 5 cm in diameter. Multiple painless EM rashes may occur, indicating disseminated infection.
The EM rash occurs, according to sources, in 80% to 90% of those infected with Borrelia. A systematic review of the medical literature showed 80% of patients have an expanding EM rash, at the site of the tick bite, although some patients with EM do not recall a tick bite. In endemic areas of the United States, homogeneously red rashes are more frequent.
A significant group of practitioners disputes the generally accepted incidence of the rash, claiming it occurs in less than 50% of infections. These practitioners suggest a condition they call "chronic Lyme" (resembling chronic fatigue syndrome or fibromyalgia) exists in the absence of evidence for Borrelia infection. Their proposed treatment of patients with months or years of antibiotics is opposed by the wider medical community's scientific consensus, since these treatments are potentially dangerous, are not based on diagnoses with objective evidence, and have been shown in clinical trials to be ineffective even when evidence of infection is present.
Read more about this topic: Erythema Chronicum Migrans
Famous quotes containing the word description:
“Everything to which we concede existence is a posit from the standpoint of a description of the theory-building process, and simultaneously real from the standpoint of the theory that is being built. Nor let us look down on the standpoint of the theory as make-believe; for we can never do better than occupy the standpoint of some theory or other, the best we can muster at the time.”
—Willard Van Orman Quine (b. 1908)
“I was here first introduced to Joe.... He was a good-looking Indian, twenty-four years old, apparently of unmixed blood, short and stout, with a broad face and reddish complexion, and eyes, methinks, narrower and more turned up at the outer corners than ours, answering to the description of his race. Besides his underclothing, he wore a red flannel shirt, woolen pants, and a black Kossuth hat, the ordinary dress of the lumberman, and, to a considerable extent, of the Penobscot Indian.”
—Henry David Thoreau (1817–1862)
“To give an accurate description of what has never occurred is not merely the proper occupation of the historian, but the inalienable privilege of any man of parts and culture.”
—Oscar Wilde (1854–1900)