In recent years a possible aetiological connection between skin sclerosis and an infection with Borrelia burgdorferi has been discussed, but this association has not yet been reported for systemic scleroderma. Several...In recent years a possible aetiological connection between skin sclerosis and an infection with Borrelia burgdorferi has been discussed, but this association has not yet been reported for systemic scleroderma. Several treatment modalities are suggested for systemic scleroderma, but no treatment has yet been found to alter the overall course of the disease. This report describes a 61-year-old woman with Raynaud’ s phenomenon, nail-fold changes and circulating anticentromere antibodies, whoshowedanabruptonsetoferythemasanddoughyswellings involving the face and upper trunk, followed by thickening and induration of the skin mimicking diffuse systemic scleroderma. Laboratory tests including enzyme-linked immunosorbent assay (ELISA), immunoblot and urine polymerase chain reaction (PCR) showed an infection with B. burgdorferi sensu lato that was successfu lly treated with intravenous ceftriaxone,anantibiotic recommended for Lyme borreliosis. Fourteen days after the end of treatment the skin was no longer stiff and indurated and had returned to its normal predisease state. This case suggests that Lyme disease should be considered in atypical cases of skin sclerosis in patients predisposed to the development of systemic scleroderma.展开更多
Background: A longer duration treatment is preferred in erythema migrans (EM) to prevent late complaints. Objectives: To determine whether 20 (20d- pt) or 14 days (14d- pt) of phenoxymethylpenicillin (PenV) have simil...Background: A longer duration treatment is preferred in erythema migrans (EM) to prevent late complaints. Objectives: To determine whether 20 (20d- pt) or 14 days (14d- pt) of phenoxymethylpenicillin (PenV) have similar efficacy in treating EM and preventing further sequelae. Patients and Methods: In a prospective double- centre study, 102 patients with EM were treated with PenV 1.5 million IU thrice daily for either 20 or 14 days and followed up for 12 months. Results: The primary cure rate after treatment with PenV was 91.5% (79.6- 97.6) for 20d- pt vs. 91.7% (77.5- 98.2) for 14d- pt; p >0.99). In 7 patients (420d- pt and 314d- pt), persistent or newly arising symptoms required retreatment. After 1 year, all patients were cured. The immune response showed no statistical difference between the treatment groups in the follow- up period. Conclusion: A 2- week treatment regimen of PenV seems to be as effective as a 3- week course with no statistical differences for clinical and serological findings after treatment.展开更多
文摘In recent years a possible aetiological connection between skin sclerosis and an infection with Borrelia burgdorferi has been discussed, but this association has not yet been reported for systemic scleroderma. Several treatment modalities are suggested for systemic scleroderma, but no treatment has yet been found to alter the overall course of the disease. This report describes a 61-year-old woman with Raynaud’ s phenomenon, nail-fold changes and circulating anticentromere antibodies, whoshowedanabruptonsetoferythemasanddoughyswellings involving the face and upper trunk, followed by thickening and induration of the skin mimicking diffuse systemic scleroderma. Laboratory tests including enzyme-linked immunosorbent assay (ELISA), immunoblot and urine polymerase chain reaction (PCR) showed an infection with B. burgdorferi sensu lato that was successfu lly treated with intravenous ceftriaxone,anantibiotic recommended for Lyme borreliosis. Fourteen days after the end of treatment the skin was no longer stiff and indurated and had returned to its normal predisease state. This case suggests that Lyme disease should be considered in atypical cases of skin sclerosis in patients predisposed to the development of systemic scleroderma.
文摘Background: A longer duration treatment is preferred in erythema migrans (EM) to prevent late complaints. Objectives: To determine whether 20 (20d- pt) or 14 days (14d- pt) of phenoxymethylpenicillin (PenV) have similar efficacy in treating EM and preventing further sequelae. Patients and Methods: In a prospective double- centre study, 102 patients with EM were treated with PenV 1.5 million IU thrice daily for either 20 or 14 days and followed up for 12 months. Results: The primary cure rate after treatment with PenV was 91.5% (79.6- 97.6) for 20d- pt vs. 91.7% (77.5- 98.2) for 14d- pt; p >0.99). In 7 patients (420d- pt and 314d- pt), persistent or newly arising symptoms required retreatment. After 1 year, all patients were cured. The immune response showed no statistical difference between the treatment groups in the follow- up period. Conclusion: A 2- week treatment regimen of PenV seems to be as effective as a 3- week course with no statistical differences for clinical and serological findings after treatment.
