Dermatological and Genital Manifestations of Lyme Disease Including Morgellons Disease

• Published in: Clinical, cosmetic and investigational dermatology Vol. 14; pp. 425 - 436
• Main Authors: Middelveen, Marianne J, Haggblad, John S, Lewis, Julie, Robichaud, Gilles A, Martinez, Roberto M, Shah, Jyotsna S, Du Cruz, Iris, Fesler, Melissa C, Stricker, Raphael B
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Antibodies; Antigens; Biopsy; borrelia burgdorferi; Calibration; Case Report; Case reports; Erythema; erythema migrans; Infections; Laboratories; Lyme disease; morgellons disease; Serology; Skin; Skin diseases; spirochetes; tickborne disease; Vagina; New Brunswick; Canada; California; United States > US; erythema migrans; Lyme disease; Borrelia burgdorferi; spirochetes; Morgellons disease; tickborne disease
• ISSN: 1178-7015; 1178-7015
• DOI: 10.2147/CCID.S299526

Although the erythema migrans (EM) skin rash is traditionally considered a hallmark of Lyme disease, other dermatological manifestations of the tickborne disease are less well known. We describe a 49-year-old woman with erosive genital ulcerations, secondary EM rashes and jagged skin lesions associated with Lyme disease. The skin rashes exhibited fibers characteristic of Morgellons disease. Molecular testing confirmed the presence of DNA in both vaginal culture and serum specimens. In further studies on a secondary EM lesion containing filaments, Gömöri trichrome staining revealed the presence of collagen in the filaments, while Dieterle and anti- immunostaining revealed intracellular and extracellular organisms. Intracellular staining for was also observed in lymphocytic infiltrates. Lyme disease may present with a variety of genital lesions and dermatological manifestations including Morgellons disease. Careful evaluation is required to determine the presence of organisms associated with these dermopathies.