Lyme Disease Lyme Arthritis :: Health Medicine

Lyme Disease Lyme Arthritis Lyme disease is a tick-transmitted inflammatory disorder characterizedby an early focal skin lesion, and afterwards a growing red area on theskin (erythema chronicum migrans or ECM). The disorder whitethorn be followedweeks later by neurological, heart or juncture abnormalities.Symptomatology The first symptom of Lyme disease is a skin lesion. Known as erythemachronicum migrans, or ECM, this usually begins as a red discoloration(macule) or as an elevated round spot (papule). The skin lesion usuallyappears on an extremity or on the trunk, especially the thigh, buttock orthe under arm. This spot expands, oft with central clearing, to adiameter as large as 50 cm (c. 12 in.). Approximately 25% of patients withLyme disease report having been bitten at that point by a tiny tick 3 to 32days before fire of ECM. The lesion may be warm to touch. Soon afteronset nearly fractional the patients develop multiple smaller lesions withouthardened cent ers. ECM generally lasts for a few weeks. Other types oflesions may subsequently appear during resolution. fountain skin lesions mayreappear faintly, sometimes before recurrent attacks of arthritis. Lesionsof the mucous membranes do not occur in Lyme disease. The most common symptoms accompanying ECM, or preceding it by a fewdays, may include malaise, fatigue, chills, fever, headache and stiff neck. Less commonly, backache, muscle aches (myalgias), nausea, vomiting, sorethroat, swollen lymph glands, and an enlarged spleen may also be present. Most symptoms are characteristically intermittent and changing, butmalaise and fatigue may linger for weeks. Arthritis is present in about half of the patients with ECM, occurringwithin weeks to months following onset and lasting as long as 2 years.Early in the illness, migratory inflammation of many joints(polyarthritis) without joint jut may occur. Later, longer attacksof swelling and pain in several large joints, especi ally the knees,typically recur for several years. The knees commonly are much moreswollen than painful they are often hot, but rarely red. Bakers cysts(a cyst in the knee) may form and rupture. Those symptoms accompanying ECM, especially malaise, fatigue and low-grade fever, may also precede or accompany recurrent attacks of arthritis.About 10% of patients develop chronic knee involvement (i.e. unremittentfor 6 months or longer). Neurological abnormalities may develop in about 15% of patients with