Bullous Lyme disease

作者：Jeffrey B. Tiger, Marshall A. Guill, Michael Chapman · 发表于：Journal of the American Academy of Dermatology · 年份：2014 · DOI：10.1016/j.jaad.2014.04.038 · 被引用次数：9 · 研究领域：Vector-borne infectious diseases、Dermatological diseases and infestations、Bartonella species infections research

To the Editor: A 57-year-old woman living in the Upper Connecticut River Valley presented in July 2011 with an acute blistering rash on her left thigh that she believed was caused by a spider bite. The lesion rapidly progressed over 4 days from a small tender red papule to a 12-cm annular, erythematous patch with a centrally located 5-cm tender, indurated bulla with surrounding vesicles (Fig 1). She also reported mild fever, headache, nausea, and arthralgia. She denied a history of a recent tick bite, hiking, or recent travel, but she did live in a wooded, rural area with numerous deer, frequently used a riding lawn mower, and stated she often saw ticks on her property.