Abstract
The patient is a 61-year-old woman who lives in Ogaki City, Gifu Prefecture. After she was back from her trip in Gunma Prefecture, she noticed annular erythema with red papule centrally on her left shoulder, and then the annular erythema gradually expanded. On the first consultation, annular erythema with 40×30cm in size and the red papule at the center was found on the left shoulder. By enzyme-linked immunosorbent assay, her serum showed positive anti-Borrelia antibody. Other laboratory examination revealed no abnormal findings. The diagnosis of Lyme disease due to Borrelia garinii and/or Borrelia afzelii was made on the basis of Western blot analysis. Skin lesion disappered after 3 days by the treatment with oral doxycycline 100mg/day. In Japan, 64 cases of Lyme disease have been reported since April 1999. Although Hokkaido is the most endemic area, there are also some reports from non-epidemic area including Tokyo and Kanagawa. Therefore, it is important to consider the possibility of Lyme disease even in the non-endemic area, when the patients have annular erythema.
