Images in Dermatology
Progressively Expanding Red Plaque on the Cheek: Erythema Migrans
Placa roja en la mejilla con crecimiento progresivo: eritema migratorio
G. Blasco-Morente
, S. Arias-Santiago, J. Orgaz-Molina, C. Garrido-Colmenero
Autor para correspondencia
Unidad de Gestión Clínica Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Blasco-Morente, S. Arias-Santiago, J. Orgaz-Molina, C. Garrido-Colmenero" "autores" => array:4 [ 0 => array:4 [ "nombre" => "G." "apellidos" => "Blasco-Morente" "email" => array:1 [ 0 => "gonzaloblascomorente@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Arias-Santiago" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Orgaz-Molina" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Garrido-Colmenero" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Gestión Clínica Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen de las Nieves, Granada, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Placa roja en la mejilla con crecimiento progresivo: eritema migratorio" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 832 "Ancho" => 990 "Tamanyo" => 112215 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 58-year-old woman was seen for a progressively enlarging erythematous lesion that had arisen on her cheek 7 days earlier. There were no associated symptoms. She had received topical antifungal treatment with no improvement, and she did not recall any trauma or insect bite. Physical examination revealed an annular erythematous plaque on the patient's right cheek, with an elevated border and partial central clearing, with no flaking, hemorrhage, or necrosis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). On a diagnostic suspicion of erythema chronicum migrans, we requested complete blood count and biochemistry, which were normal, and serology for <span class="elsevierStyleItalic">Borrelia</span> IgM antibodies, which was positive; serology performed 3 weeks later showed the development of <span class="elsevierStyleItalic">Borrelia</span> IgG antibodies. Culture for fungi and bacteria was negative. Doxycycline, 100<span class="elsevierStyleHsp" style=""></span>mg/12<span class="elsevierStyleHsp" style=""></span>h, was administered for 3 weeks, achieving complete resolution. Lyme disease is caused by the spirochete <span class="elsevierStyleItalic">Borrelia burgdorferi</span> transmitted by the bite of ticks of the genus <span class="elsevierStyleItalic">Ixodes</span>. The initial stage of the disease presents with an influenza-like illness and typical skin manifestations, with erythema chronicum migrans, characterized by progressive spread with central clearing. Untreated, the clinical course of Lyme disease is similar to that of syphilis, with an early localized stage, an early disseminated stage, and a late persistent final stage. Early antibiotic treatment can prevent progression to subsequent phases, which are associated with more severe organ involvement.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Blasco-Morente G, Arias-Santiago S, Orgaz-Molina J, Garrido-Colmenero C. Placa roja en la mejilla con crecimiento progresivo: eritema migratorio. Actas Dermosifiliogr. 2016;107:686.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 832 "Ancho" => 990 "Tamanyo" => 112215 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010700000008/v2_201704100057/S1578219016301536/v2_201704100057/en/main.assets" "Apartado" => array:4 [ "identificador" => "41141" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Dermatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010700000008/v2_201704100057/S1578219016301536/v2_201704100057/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016301536?idApp=UINPBA000044" ]
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