Overview
Late cutaneous Lyme borreliosis encompasses a spectrum of skin manifestations that can arise weeks to years after initial infection with Borrelia species. These include conditions such as borrelial lymphocytoma and acrodermatitis chronica atrophicans 1.Diagnosis
Diagnosis is primarily clinical, supported by serological testing 1.
Recommended diagnostic approaches include clinical confirmation, stage-related laboratory diagnosis, and treatment of specific manifestations 1.Management
Treatment recommendations are stage-related and address specific manifestations like erythema migrans, multiple erythemata migrantia, borrelial lymphocytoma, and acrodermatitis chronica atrophicans 1.
The Cochrane network analysis on erythema migrans treatment showed limited findings 1.Key Recommendations
Recommendations exist for confirming a clinical diagnosis of cutaneous Lyme borreliosis 1. (Evidence: Expert opinion)
Recommendations are provided for stage-related laboratory diagnosis in cutaneous Lyme borreliosis 1. (Evidence: Expert opinion)
Recommendations are available for the treatment of different manifestations of cutaneous Lyme borreliosis, including erythema migrans, multiple erythemata migrantia, borrelial lymphocytoma, and acrodermatitis chronica atrophicans 1. (Evidence: Expert opinion)References
1 Hofmann H, Fingerle V, Rauer S, Hunfeld KP, Huppertz HI, Krause A. Cutaneous Lyme borreliosis: Guideline of the German Dermatology Society. German medical science : GMS e-journal 2025. link