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» LymeNet Flash » Questions and Discussion » Medical Questions » Granuloma annulare rash in Borrelia/Lyme infection

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Author Topic: Granuloma annulare rash in Borrelia/Lyme infection
nenet
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Holy Moly!!

I had NO IDEA the evidence for a link with Granuloma annulare and Borrelia in recent studies was this strong.

This is amazing. I would think that based on these and other recent studies, if anyone has Granuloma annulare, they should try to get FFM (focus-floating microscopy) of their GA biopsy.


http://www.ncbi.nlm.nih.gov/pubmed/18616764

Granuloma annulare--a manifestation of infection with Borrelia?

"BACKGROUND: Among the theories of origin of granuloma annulare (GA) are those of infection. Reports gave raise to the assumption that there is evidence for Borrelia as the causing agent. METHODS: To assess the evidence for infection with Borrelia in GA, tissue sections were stained with a polyclonal Borrelia antibody.

With focus-floating microscopy (FFM), slides were scanned at a 200- to 400-fold magnification. Part of the material was also investigated with a Borrelia-specific polymerase chain reaction (PCR).

RESULTS: A total of 157 biopsies of GA have been investigated. Using FFM, Borrelia were detected in 127 cases of GA (80.9%). Borrelia were more prominent in localized (85.2%) than in diffuse GA (62.1%).

In 27 cases of GA analysed by PCR, Borrelia-specific DNA could be detected in only one case (3.7%), but was positive in 21 cases by FFM (77.8%). About 93.3% of 15 control cases of borreliosis were positive with FFM and 46.7% with PCR, while all controls other than borreliosis remained negative for spirochetes.

CONCLUSION: FFM is a reliable method to show Borrelia in tissue sections of GA, which is more sensitive than PCR. This underlines the possibility that Borrelia are involved specifically in the aetiology and pathogenesis of GA."

PMID: 18616764


Granuloma annulare displaying pseudorosettes in Borelia infection

"Aims: In 2003, pseudorosettes were described as highly suspicious of infection by Borrelia burgdorferi sensu lato in the appropriate clinical context. Nevertheless, such a pattern has been described in the literature in other non-infectious conditions.

On the other hand, granuloma annulare (GA) has been recently closely associated with infection by Borrelia. We investigated how frequently pseudorosettes can be detected in common GA cases confirmed for Borrelia by PCR.

Methods and results: We studied 13 biopsies of non-interstitial GA and 2 biopsies of interstitial GA from patients without clinical suspicion of borrelial infection.

We also performed immunohistochemical studies in all the biopsies, using the CD-68 antibody. Molecular studies with PCR were performed with beta-globin PCR (human DNA).

Borrelial DNA was confirmed by amplifying the OspA gene and intergenic rrf-rrl region. We found histiocytic pseudorosettes in 13 biopsies (86.66%). Human DNA was successfully amplified from 8 of 13 paraffin-embedded skin samples.

From these we amplified borrelial DNA in 5 of 8 samples. Out of the 8 cases in which human DNA was amplified, a correlation between pseudorosettes and the molecular tests (Borrelia DNA) was confirmed in 5 instances.

Conclusions: a) Pseudorosettes are not an unusual finding in common granuloma annulare; b) Borrelia is present in (most) cases of granuloma annulare; and c) Pseudorosettes seem to be a good morphological sign predictive of infection with Borrelia in granuloma annulare."

Acta dermatovenerologica Alpina, Panonica, et Adriatica. 01/01/2009; 17(4):171-6.
ISSN: 1318-4458

full article pdf with images here:
ibmi.mf.uni-lj.si/acta-apa/acta-apa-08-4/4.pdf

[PMID: 19104742] direct link to abstract:
http://www.ncbi.nlm.nih.gov/pubmed/19104742

[ 07-26-2009, 12:13 PM: Message edited by: nenet ]

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aiden424
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I've had granuloma annulare since about ten days after I first got sick. It started as a huge circle on the top of my right foot.

I've had it for over 24 years. It moves around, but never has it ever totally left.


Kathy

[ 06-27-2009, 10:17 PM: Message edited by: aiden424 ]

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klutzo
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I've had it three times in the same spot, while on high doses of Samento to treat Lyme. When I backed down the dosage, it finally slowly cleared out.

klutzo

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Leelee
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I have a difficult time distinguishing granuloma from other skin issues I have.

I am not sure if I have it or not.

--------------------
The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. Martin Luther King,Jr

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aiden424
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I had a biopsy done on mine.

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nenet
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Wow, this is very interesting you all, thanks for posting about your experiences with this.

I was very interested in this study for several reasons, but one of them being I have some round reddish-brown areas that are almost a perfect circle, filled in, and flat. GA is the only thing I can figure they could be. They do not itch. They started after I ramped up my antibiotic treatment and really started feeling a difference.

I also get things on my fingers every once in a while that look like the kind of GA people can get on their hands - one or two little tiny bumps around the fingers, that will come and go within days or weeks.

If we had income right now I would be looking into getting a biopsy of these spots. The biggest one is maybe a half-inch diameter, and I have 4 of them on my thighs.


Would anyone be up for posting a picture of their Granuloma annulare rashes? I would be very very grateful. I need to figure out what this is.

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AliG
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very interesting, thanks for posting this [Smile]

some images

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Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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nenet
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Thanks AliG. I already did a bunch of searching through google images, but the link should be helpful to others checking this out and unaware what various granuloma annulare rashes can look like.


I was hoping to see pics of people's GA that know they have Lyme Disease, especially anyone that has had a positive Lyme biopsy of one.


aiden424, may I ask what your biopsy result was? Was it tested for Lyme?

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nellypointis
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quote:
Originally posted by aiden424:
I had a biopsy done on mine.

I did too but nothing of interest to the dermatologist was reported.

If you want to see pictures of my GA
http://groups.yahoo.com/group/EuroLyme/photos/album/792214482/pic/list

Nelly

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Dekrator48
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My adult daughter has these....the dermatologist did a biopsy.

When we found out what they were I saw that same study online and she showed it to the dermatologist and told the Dr she thought she had chronic lyme.

At the time, she had not had an Igenex western blot yet, but I knew from the symptom list that she also had lyme and co's.

The Dr gave her a steroid cream which she did not use on the advice of my LLMD and myself.

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The fibromyalgia I've had for 32 years was an undiagnosed Lyme symptom.

"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". -Jeremiah 29:11

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nenet
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[I added this info in this post to the top as well, so it isn't missed]

Holy Moly!!

I had NO IDEA the evidence for a link with Granuloma annulare and Borrelia in recent studies was *this* strong.

This is amazing. I would think that based on these and other recent studies, if anyone has Granuloma annulare, they should try to get FFM (focus-floating microscopy) of their GA biopsy!


http://www.ncbi.nlm.nih.gov/pubmed/18616764

J Cutan Pathol. 2008 Nov;35(11):1050-7. Epub 2008 Jun 18.Click here to read Links


Granuloma annulare--a manifestation of infection with Borrelia?

Ziemer M, Grabner T, Eisendle K, Baltaci M, Zelger B.


Department of Dermatology and Venereology, Friedrich-Schiller-University, Jena, Germany.


"BACKGROUND: Among the theories of origin of granuloma annulare (GA) are those of infection. Reports gave raise to the assumption that there is evidence for Borrelia as the causing agent. METHODS: To assess the evidence for infection with Borrelia in GA, tissue sections were stained with a polyclonal Borrelia antibody.

With focus-floating microscopy (FFM), slides were scanned at a 200- to 400-fold magnification. Part of the material was also investigated with a Borrelia-specific polymerase chain reaction (PCR).

RESULTS: A total of 157 biopsies of GA have been investigated. Using FFM, Borrelia were detected in 127 cases of GA (80.9%). Borrelia were more prominent in localized (85.2%) than in diffuse GA (62.1%).

In 27 cases of GA analysed by PCR, Borrelia-specific DNA could be detected in only one case (3.7%), but was positive in 21 cases by FFM (77.8%). About 93.3% of 15 control cases of borreliosis were positive with FFM and 46.7% with PCR, while all controls other than borreliosis remained negative for spirochetes.

CONCLUSION: FFM is a reliable method to show Borrelia in tissue sections of GA, which is more sensitive than PCR. This underlines the possibility that Borrelia are involved specifically in the aetiology and pathogenesis of GA."


PMID: 18616764 [PubMed - indexed for MEDLINE]

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Dr. C's Western Blot Explanation

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nenet
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Does anyone else have Granuloma annulare?

If you have/had an LLMD, did they find it significant?

Did you have it biopsied for Lyme?

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aiden424
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I never had mine biopsied for lyme. Where would you send it?

I just had a huge raised circle on the top of my right foot and a dermatoligist did a biopsy on it and said it was granuloma annulare.

I know that for me there is a connection with it and being sick. I got it 10 to 14 days after I got sick and have had it since.

Kathy

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nenet
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Thank you very much Kathy. That's really interesting.

I'm not sure where you would send the biopsy to test for Lyme - good question. I should try to look into that. I will definitely post the answer here, and if there is no place I can find I will let you know that too.


Is there anyone else with GA? Or maybe has a rash they can't figure out?

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aiden424
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I don't think I'd send in a biopsy to see if lyme was there anyway. I've already had a positive Lyme test. Unless insurance payed for it.

I thought it was a Bart rash. I had a positive test for Bart too. If you look at Bart pictures, it looks like that too.

This is really interesting. I don't know how you'd know if it was from Bart or Lyme.

Kathy

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Zebco 33
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Can this kind of Granuloma turn white and get crusty?

I'm on 200 mg. of Doxy and have a positive Lyme Dx.

I asked my husband after an epsom salt bath to look at it and he said it looked like Small Pox.

I said "What?" Thanks, but you are no help and not doctor mister!

Now, I'm wondering if it is a granuloma. Sad to say, I took matters into my own hands and just rubbed and ripped it off. It seemed loose as I was drying off with a towel, about 5 inches. under right arm towards the back.

It was about an inch wide and it has been bleeding like crazy.

I have a feeling it may come back. It seemed scab like and quite hard as I inspected it.

Sorry if it sounds gross, but I couldn't word it any other way.

Now, I wish I hadn't done this as I have a dr. appt. on the 16th.

I will show him where it was.

Is there a way for him to do a bioposy now that I've removed it?

If not, I'll have a biopsy done if it comes back.

Very interesting posts. Thank you so much.

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aiden424
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Mine have always been raised reddish purple patches of skin. It has never itched or been crusty.

Kathy

[ 07-10-2009, 10:40 AM: Message edited by: aiden424 ]

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nenet
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Zebco, that is very interesting. I would definitely bring it up with your LLMD.

Also, have some pictures taken of it even though it has been messed with. I would document the site with photos as it heals, or if it develops into something again.

You might be able to get a biopsy of it, it totally depends on what might be there, and how active and deep the infection is (if there is one causing this).

However, I am still trying to find out if Focus Floating Microscopy is available for commercial lab testing (for people like us).

I don't know if it might be Granuloma annulare or some other Lyme manifestation - apparently there are many different types of skin problems that can be caused by Lyme.

You might want to read this thread about a couple of them:

Possible Role of Bb (sl)/Lyme Infection in Lichen Sclerosus & localized scleroderma

http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/83335


If you are hoping to compare what you had/have, I would search google and google images for each of these conditions.

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nenet
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I forgot to mention, there are several different types of Granuloma annulare. Some can be itchy, flat or raised, varying colors, different places on body.

I know you can get some on fingers/hands that are more like small bumps that can itch.

I am pretty sure I ran across some that were patchy/scaly in my searches. If I find them I will post em.

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"Long-Term Antibiotic Therapy Improves Persistent Symptoms Associated with Lyme Disease"

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Zebco 33
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Thanks Nenet....Will get reading and address this.

Really appreciate your input.

I didn't realize there were different kinds of skin problems associated with my lyme disease.

So much to learn.

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