Erythema migrans with multiple lesions.

Introduction. Erythema migrans with multiple lesions is observed in Europe in only 5-20 p. 100 of Borrella infections. The number of lesions observed simultaneously in one patient is less than 7, considering all the cases pub lished in the literature to date. Case reports. We report three patients wh o presented multiple macular, erythematous and centrifugal lesions localize d on the trunk and the limbs. The first patient presented about thirty lesi ons, the second more than seventy, and the third about twenty. Serology inv estigation and immunoblots allowed to establish the diagnosis of a recent B orrelia Burgdorferi infection, with multiples lesions of erythema migrans. PCR performed on a skin biopsy of one of the patients confirmed the presenc e of Borrelia burgdorferi. Response to antibiotic therapy was immediate in all 3 patients. Discussion. These 3 cases are of particular interest becaus e the number of simultaneous lesions is much higher than what is reported i n the European literature. These observations remind the clinician that the diagnosis of erythema migrans with multiple lesions should be included, in Europe as well, in the differential diagnosis of multiple annular dermatos es.