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 subsequently a growing wild area on theskin (erythema chronicum migrans or ECM). The disorder may be followedweeks later by neurological, heart or joint abnormalities.Symptomatology The first prognostic of Lyme disease is a skin lesion. Known as erythemachronicum migrans, or ECM, this normally begins as a red discoloration(macule) or as an tremendous round spot (papule). The skin lesion usuallyappears on an extremity or on the trunk, especially the thigh, buttock orthe under arm. This spot expands, frequently with central clearing, to adiameter as expectant as 50 cm (c. 12 in.). Approximately 25% of patients withLyme disease report having been bitten at that site by a tiny tick 3 to 32days before onset of ECM. The lesion may be warm to touch. briefly afteronset nearly half the patients develop multiple little lesions withouthardene d centers. ECM generally lasts for a few weeks. Other types oflesions may subsequently appear during resolution. Former skin lesions mayreappear faintly, sometimes before repeated 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, fag, chills, fever, headache and stiff neck. Less commonly, backache, musculus 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 weary may linger for weeks. Arthritis is present in about half of the patients with ECM, occurring indoors weeks to months following onset and lasting as long as 2 years.Early in the illness, migratory inflammation of many joints(polyarthritis) without joint pretentiousness may occur. Later, longer attacksof swelling and pain in several large joints, especially the knees,typically recur for several years. The knees commonly are some(prenominal) moreswollen than painful they are often hot, but seldom 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