Cutaneous Manifestations in Ixodes-borne Borrelia Spirochetosis

TL;DR: It has been demonstrated that Lyme disease is caused by spirochetes transmitted by Ixodes dammini, which has now been named 6.

Abstract: Soft ticks of the species Ornithodoros are known to transmit Borrelia spirochetes, causing relapsing fever.' Europeans have long recognized (/xodes) ticks as being associated with erythema chronicum migrans (ECM),̂ •* lymphadenosis benigna cutis (LABC)/''and acrodermatitis chronica atrophicans (ACA).^ Among other etiologic agents of these disorders, spirochetes have been suspected.°"'^ In the United States, ECM was not described until 1970.'^ A few years later, Steere et al. reported on a new form of inflammatory arthritis in the community of Lyme, Connecticut.''' In 1976, Lyme arthritis was linked to a preceding erythema. Subsequent manifestations from the nervous system and from the heart were also described.'^ The name Lyme disease was coined. Lyme disease may start with ECM at the site ofa tick bite. Fever, headache, myalgias, and arthralgias may accompany this early phase of the disease. Weeks to many months after the onset, these may be followed by meningitis, cranial or peripheral neuropathies, myocarditis, and—in a high frequency—arthritis. With the use of spirochetal cultivation and serologic tests, it has been demonstrated that Lyme disease is caused by spirochetes transmitted by Ixodes dammini.^^ Other species of hard ticks of the genus Ixodes (I. pacificus and /. scapularis) can also be infected with spirochetes. American spirochetal strains have been studied by DNA homology techniques'' and comparison of guaninexytosine ratios.'" The results indicate that the different strains belong to a new or previously unrecognized species oi Borrelia, which has now been named 6. burgdorferi.^^