ArticleInfection2021
The presenting characteristics of erythema migrans vary by age, sex, duration, and body location.
Article in Infection, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 22 citations in OpenAlex.
- Borrelia burgdorferi disrupts gut barrier functions and microbiota-antibody interactions.The Journal of experimental medicine · 2026Article
- Antiphospholipid antibodies in acute and post-treatment Lyme disease.Infection and immunity · 2026Article
- Evaluation of standard and modified two-tiered testing algorithms using well-characterized early Lyme disease samples.Journal of clinical microbiology · 2026Article
- Multiplexed single-tier immunoassay for improved Lyme disease diagnosis across all disease stages.Research square · 2026Article
- Sex and menopause-based differences in presentation of early Lyme disease: A prospective cohort study.Clinical and experimental medicine · 2026Article
- Article
- Lyme Disease Biobank: 10 years of 3 month follow-up visits from 2014 to 2023.Frontiers in medicine · 2025Article
- Antibodies toMicrobiology spectrum · 2024Observational
- Diffusive mediator feedbacks control the health-to-disease transition of skin inflammation.PLoS computational biology · 2024Article
- A sex-based analysis of complete blood count features during acute, untreated Lyme disease.Frontiers in medicine · 2024Article
- Leveraging machine learning approaches for predicting potential Lyme disease cases and incidence rates in the United States using Twitter.BMC medical informatics and decision making · 2023Article
- The Interaction of Borrelia burgdorferi with Human Dendritic Cells: Functional Implications.Journal of immunology (Baltimore, Md. : 1950) · 2023Article
- Initial Presentation and Time to Treatment in Early Lyme Disease.The American journal of tropical medicine and hygiene · 2023Article
- The history of Lyme disease in Italy and its spread in the Italian territory.Frontiers in pharmacology · 2023Article
- Does Biological Sex Matter in Lyme Disease? The Need for Sex-Disaggregated Data in Persistent Illness.International journal of general medicine · 2023Article
- The Spectrum of Erythema Migrans in Early Lyme Disease: Can We Improve Its Recognition?Cureus · 2022Article
- Unconventional Approaches to Direct Detection of Borreliosis and Other Tick Borne Illnesses: A Path Forward.Journal of cellular immunology · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe erythema migrans (EM) skin lesion is often the first clinical sign of Lyme disease. Significant variability in EM presenting characteristics such as shape, color, pattern, and homogeneity, has been reported. We studied associations between these presenting characteristics, as well as whether they were associated with age, sex, EM duration, body location, and initiation of antibiotics.
methodsTwo hundred and seventy one adult participants with early Lyme disease who had a physician-diagnosed EM skin lesion of ≥ 5 cm in diameter and ≤ 72 h of antibiotic treatment were enrolled. Participant demographics, clinical characteristics, and characteristics of their primary EM lesion were recorded.
resultsAfter adjusting for potential confounders, EM size increased along with increasing EM duration to a peak of 14 days. Male EM were found to be on average 2.18 cm larger than female EM. The odds of a red (vs blue/red) EM were 65% lower in males compared to females, and were over 3 times as high for EM found on the pelvis, torso, or arm compared to the leg. Age remained a significant predictor of central clearing in adjusted models; for every 10-year increase in age, the odds of central clearing decreased 25%.
conclusionsGiven that EM remains a clinical diagnosis, it is essential that both physicians and the general public are aware of its varied manifestations. Our findings suggest possible patterns within this variability, with implications for prompt diagnosis and treatment initiation, as well as an understanding of the clinical spectrum of EM.
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