Therapy of lyme disease

Borrelia burgdorferi is highly susceptible to antibiotic treatment and the majority of patients profit from this treatment. Antibiotic selection, dose and route of administration, and duration of therapy for Lyme disease depend on the patient\u2019s clinical manifestations and stage of disease, age, pregnancy status, as well as the presence of other concomitant diseases and/or allergies. Despite an appropriate antibiotic therapy, about 10-20% of patients may show persistent or recurrent symptoms ("post-treatment Lyme disease syndrome"). In the present paper we will briefly discuss the post-exposure prophylaxis, before going on to talk over the current therapeutic approach regarding the management of Lyme disease according to the stage of disease/clinical manifestations. Finally, we will discuss the main treatment-related phenomenon, the Jarisch-Herxheimer reaction, and the treatment modalities for special categories of patients, namely pregnant women, subjects suffering from post-treatment Lyme disease syndrome, possible Borrelia-associated skin manifestations, coinfections and Baggio-Yoshinary syndrome

Adalimumab-associated spondylodiscitis: a new or underestimated side effect?

N/

Monolateral Grover’s disease with blaschkoid distribution.

No abstract availabl

The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era

Background: Erythema migrans (EM) is the hallmark manifestation of the Lyme borreliosis (LB), and therefore its presence and recognition are sufficient to make a diagnosis and to start proper antibiotic treatment to attempt to eradicate the infection. Methods: In this study we compared the clinical data of 439 patients who presented an EM either according to the diagnostic modality through physical assessment or through telemedicine. Conclusions: Our data clearly show that telemedicine for EM diagnosis is useful as it enables prompt administration of appropriate antibiotic therapy, which is critical to avoid complications, especially for neurologic and articular entities. Therefore, telemedicine is a tool that could be adopted for the diagnosis of Lyme disease both by specialized centers but also by general practitioners

Staphylococcus lugdunensis cutaneous infection with sporotrichoid distribution

We report the occurrence of Staphylococcus lugdunensis cutaneous infection with sporotrichoid distribution of the left lower limb of a 60-year-old man. Recent studies have confirmed that Staphylococcus lugdunensis is a significant pathogen in causing skin and soft tissue infections that usually manifest in abscesses, surgical wound infections, and cellulitis. It used to be considered a skin commensal bacteria, but if unrecognized it can lead to  fulminant endocarditis, meningitis, skin abscesses, peritonitis, and spondylodiscitis

Erythema chronicum migrans and its clinical variants: a review

Erythema chronicum migrans (ECM) is the pathognomonic sign of the early stage of Lyme disease, a tick-borne illness caused by pathogenic species of Borrelia, a genus of bacteria of the spirochete phylum. Lyme disease has a broad spectrum of clinical manifestations that can vary in severity and imitate other diseases. ECM consists in a slow enlarging erythema with central clearing. Its recognition allows to state the diagnosis and prescribe the correct therapy and blood tests. But beside the classical manifestation of ECM, some other peculiar variants are possible, such as the vesiculobullous, the purpuric-hemorrhagic, the urticarial, the panniculitis-erysipeloid and the necrotic variant. It is important to know these variants in order to recognize Lyme disease in its early stage, and to avoid sequelae that can involve joints, hearts, central and peripheral nervous system. We present our experience with iconographic examples and check the literature about the possible manifestations of ECM

Erythema chronicum migrans and its clinical variants: a review

Erythema chronicum migrans (ECM) is the pathognomonic sign of the early stage of Lyme disease, a tick-borne illness caused by pathogenic species of Borrelia, a genus of bacteria of the spirochete phylum. Lyme disease has a broad spectrum of clinical manifestations that can vary in severity and imitate other diseases. ECM consists in a slow enlarging erythema with central clearing. Its recognition allows to state the diagnosis and prescribe the correct therapy and blood tests. But beside the classical manifestation of ECM, some other peculiar variants are possible, such as the vesiculobullous, the purpuric-hemorrhagic, the urticarial, the panniculitis-erysipeloid and the necrotic variant. It is important to know these variants in order to recognize Lyme disease in its early stage, and to avoid sequelae that can involve joints, hearts, central and peripheral nervous system. We present our experience with iconographic examples and check the literature about the possible manifestations of ECM

Carcinoma cuniculatum: usefulness of radiological assessment

6noreservedmixeddi Meo, Nicola; Stinco, Giuseppe; Nan, Katiuscia; Degrassi, Ferruccio; Cova, Maria Assunta; Trevisan, Giustodi Meo, Nicola; Stinco, Giuseppe; Nan, Katiuscia; Degrassi, Ferruccio; Cova, Maria Assunta; Trevisan, Giust

Interobserver agreement on dermoscopic features of small basal cell carcinoma (<5 mm) among low-experience dermoscopists

The basal cell carcinoma (BCC) assessment in dermoscopy is based on the recognition of specific characteristics synthesized and described as classical and non-classical criteria, but which may not necessarily present all at the same time. Consequently, a deep knowledge in detecting the aforementioned dermoscopic criteria is crucial in diagnosis. The aim of the study was to evaluate which criteria are more frequently recognized among a group of low-experienced dermoscopists when confronted with the difficult diagnosis of BCC with a diameter lower than 5 mm. We examined 100 BCC finding that data displays a full agreement only for one classical criterion, the lack of pigmented network (Fleiss' \u3ba = 1), while among other classical criteria only arborizing vessels and ulceration exhibit a good agreement among observers (Fleiss' \u3ba > 0.40). Analyzing non-classical criteria, only blue-whitish veil and blue in-focus dots show a good agreement among low-experience observers (Fleiss' \u3ba > 0.40). It is evident that in small size BCC classic dermoscopic criteria are often substituted by non-classical criteria, which represent the neoplasm's early phase. Thus, it is of importance, especially for low-experience dermoscopists, to analyze even the non-classical criteria in order to obtain a diagnosis of early BCC. \ua9 2016 Japanese Dermatological Associatio