The timely diagnosis of early disseminated Lyme disease presenting as multiple secondary erythema migrans lesions is sometimes delayed because this stage is infrequently encountered in a general practice. We report a case of a 60-year-old woman whose initial complaints of an erythematous, "burning" rash and flu-like symptoms led to several laboratory tests with no specific diagnosis. The correc...

The cluster of 39 children with a presumptive diagnosis of juvenile rheumatoid arthritis in Connecticut, around the town of Old Lyme, initiated the research which eventually led to the arthritis being named Lyme arthritis.' The association with a multisystem illness then caused the syndrome to be redefined as Lyme disease. Epidemiologically, an infectious aetiology appeared probable, with ticks...

This paper reports an interesting development in a 64 year old female originally referred for evaluation of oral lichenoid lesions. The patient had a previous diagnosis of discoid lupus erythematosus of the skin. The presenting oral clinical appearance varied between lichenoid areas and ectopic erythema migrans. At initial presentation the patient had an exophytic lesion on the vermilion of the...