A 3-year-old male presented due to an approximately 4-week history of a skin lesion on the scrotum. Clinical examination found a solitary, painless, dark red plaque with a smooth surface. Previous treatment with glucocorticoid-containing creams had failed to improve findings. Upon targeted questioning, the mother reported that the child had received a tick bite on the scrotum several months earlier. Further laboratory-based diagnostic investigations revealed—both in the screening test (IgG/IgM enzyme immunoassay) and in the confirmatory test (IgG/IgM immunoblot)—active infection with Borrelia burgdorferi. Based on history, clinical findings, and positive serology, we diagnosed borrelial lymphocytoma and initiated 14-day antibiotic treatment with azithromycin. Follow-up at 8 weeks showed complete resolution of the lesion. Borrelial lymphocytoma (or lymphadenosis benigna cutis) is a benign pseudolymphoma at the site of a tick bite in the early phase of Lyme disease. Antibiotic therapy can always be initiated immediately if the clinical picture is unequivocal. Predilection sites include ear lobes, nipples, and the anogenital region. Children are significantly more frequently affected than adults.
Translated from the original German by Chrstine Rye.
Cite this as: Rezazadegan R, Koushk-Jalali B, Kreuter A: Borrelial lymphocytoma.
Footnotes
Conflict of interest statement:
The authors state that no conflict of interest exists.