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Lyme Arthritis

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Lyme disease is a tick-transmitted inflammatory disorder

characterized by an early focal skin lesion, and subsequently a growing

red area on the skin (erythema chronicum migrans or ECM). The disorder

may be followed weeks later by neurological, heart or joint

abnormalities.





Symptomatology

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The first symptom of Lyme disease is a skin lesion. Known as

erythema chronicum migrans, or ECM, this usually begins as a red

discoloration (macule) or as an elevated round spot (papule). The skin

lesion usually appears on an extremity or on the trunk, especially the

thigh, buttock or the under arm. This spot expands, often with central

clearing, to a diameter as large as 50 cm (c. 12 in.). Approximately

25% of patients with Lyme disease report having been bitten at that

site by a tiny tick 3 to 32 days before onset of ECM. The lesion may be

warm to touch. Soon after onset nearly half the patients develop

multiple smaller lesions without hardened centers. ECM generally lasts

for a few weeks. Other types of lesions may subsequently appear during

resolution. Former skin lesions may reappear faintly, sometimes before

recurrent attacks of arthritis. Lesions of the mucous membranes do not

occur in Lyme disease.



The most common symptoms accompanying ECM, or preceding it by a

few days, may include malaise, fatigue, chills, fever, headache and

stiff neck. Less commonly, backache, muscle aches...