Overview.
Borrelia burgdorferi erythema, also known as contact borrelia burgdorferi or borrelia burgdorferi dermatitis, is a kind of acute erythema-like damage skin disease. The disease occurs all over the world, and is mainly found in pastoral areas such as northeast and northwest Inner Mongolia, mainly sheep type, cattle type is found in larger cities, and pig type is rare; the incidence rate of male is higher than that of female, which may be attributed to the higher chance of contact with diseased animals. The main source of infection is sick sheep and cattle, whose secretions are highly contagious, and drinking unsterilized milk of sick animals can be infected orally, with less chance of human-to-human transmission.
Etiology
Mostly seen in veterinarians or people in contact with brucellosis-infected animals. Borrelia burgdorferi is divided into sheep type, cattle type and pig type, it is a kind of Gram-negative short bacillus, and it is most common in this type, but there is no Borrelia burgdorferi found in the skin lesions of the patients, so it is proposed that this disease is a hypersensitivity reaction to the antigen of Borrelia burgdorferi.
Symptoms
Itchy red blotches, papules, or wheals develop at the site of contact within a few hours after exposure to secretions from an animal infected with Borrelia burgdorferi, and may subside spontaneously after a few days. In more serious cases, most scattered follicular papules appear within 48 hours, and evolve into blisters and pustules, and later the blisters or pustules crust, the tissue under the scabs necrosis, and heal after 10 to 14 days, leaving a small scar, and secondary erythema multiforme may also appear on non-contact sites. If the skin is infected with Borrelia burgdorferi after abrasion, it can also cause painless ulcers. The patient has no systemic symptoms such as fever.
Examination
Laboratory tests: skin test with B. burgdorferi antigen is strongly positive.
Diagnosis
Diagnosis can be made according to the characteristics of the susceptible population and clinical manifestations, combined with laboratory tests.
Treatment
1. Avoid contact with diseased animals, scratching, washing with soap and hot water, and not using stimulating drugs.
2. Internal medicine is mainly used to stop itching and desensitize. Available antihistamines, vitamin C, calcium gluconate, severe cases can be short-term application of corticosteroids.
3. The principle of traditional Chinese medicine is to clear away heat and detoxify the toxin, and the formula is Erythema detoxification soup plus reduction.
4. Local therapy without oozing can be used in glycerite lotion, plus appropriate amount of phenol (carbolic acid) camphor, or menthol to stop itching. When there is redness, swelling, blisters and little exudate, zinc oxide oil can be used externally, and when combined with infection, isacridine (Livanol) can be added.
Prevention
1. Dispose of sick animals in time.
2. Strengthen the quarantine of meat and dairy products, and residents should eat cooked meat and dairy products.
3. People who have long-term contact with livestock should be vaccinated regularly with Brucella vaccine.
Prognosis
The disease will be cured after 10-14 days, leaving tiny scar, and secondary erythema multiforme may also appear on non-contact areas.