Possible Role of Borrelia burgdorferi Sensu Lato Infection in Lichen Sclerosus.
Objective: To assess the evidence for Borrelia burgdorferi sensu lato infection in patients with lichen sclerosus by focus-floating microscopy. Setting: Dermatology department of a university hospital.
Design: Tissue sections were stained with a polyclonal B burgdorferi antibody using standard histological equipment and then scanned simultaneously in 2 planes: horizontally in a serpentinelike pattern and vertically by focusing through the thickness of the section, ie, focus-floating microscopy.
Part of the material was also investigated by Borrelia-specific polymerase chain reaction. Patients: The study population comprised 61 cases of lichen sclerosus and 118 controls (60 negative controls and 68 positive controls).
Main Outcome Measure: The presence ofB burgdorferi sensu lato within tissue specimens. Results: Using focus-floating microscopy, we detected Borrelia species in 38 of 60 cases (63%) of lichen sclerosus and in 61 of 68 (90%) of positive controls of classic borreliosis, but Borrelia species were absent in all negative controls.
Borrelia species were detected significantly more often in early inflammatory-rich (31 of 39 [80%]) than in late inflammatory-poor (7 of 21 [33.3%]) cases (P=.001). Polymerase chain reaction findings were positive in 25 of 68 positive controls (37%) and negative in all 11 cases of lichen sclerosus and all 15 negative controls.
Conclusions: Focus-floating microscopy is a reliable method to detect Borrelia species in tissue sections. The frequent detection of this microorganism, especially in early lichen sclerosus, points to a specific involvement of B burgdorferi or other similar strains in the development or as a trigger of this disease.
Melanie Reber
Frequent Contributor (5K+ posts)
Member # 3707
posted
Here is another from the same authors:
...
CLINICAL AND LABORATORY INVESTIGATIONS
Morphoea: a manifestation of infection with Borrelia species? K. Eisendle, T. Grabner and B. Zelger Department of Dermatology and Venereology, Innsbruck Medical University, Anichstra�e 35, 6020 Innsbruck, Austria
Background Morphoea or localized scleroderma is a cutaneous inflammatory disease with still unknown aetiology. Borrelia burgdorferi as causative agent has been discussed controversially.
Objectives To assess the evidence for infection with B. burgdorferi in patients with morphoea by focus-floating microscopy (FFM).
Methods Using standard histological equipment, tissue sections stained with a polyclonal B. burgdorferi antibody were simultaneously scanned through in two planes: horizontally as in routine cytology, and vertically by focusing through the thickness of the section, i.e. FFM. Part of the material was also investigated with a Borrelia-specific polymerase chain reaction (PCR).
Results One hundred and twenty-two cases of morphoea and 68 controls (58 negative and 10 positive by PCR) were investigated for the presence of Borrelia within tissue specimens. Using FFM Borrelia was detected in 84 cases (68�9%) of morphoea and in all positive controls, but was absent in all negative controls.
Borrelia was significantly more frequent in early inflammatory-rich (75%) than late inflammatory-poor (53%) cases (P = 0�018). What seemed to be vital microorganisms were mostly found close to the active border, while degenerated forms were more common in fibrosclerotic parts. The presence of B lymphocytes determined by CD20 staining proved to be a good positive predictor of the microorganism (correlation 0�85, P < 0�001). Borrelia-specific DNA was detected in only one of 30 cases of morphoea analysed by PCR.
Conclusions FFM is a reliable and highly sensitive method to detect Borrelia in tissue sections. The frequent detection of this microorganism in morphoea points to a specific involvement of B. burgdorferi or other similar strains in the development of or as a trigger of this disease.
nenet
Frequent Contributor (1K+ posts)
Member # 13174
posted
Thanks bettyg, and wow, thank you Melanie.
By the way Melanie, would you happen to have any idea about focus-floating microscopy (FFM) and whether it might be available through commercial labs yet?
I am trying to find out if those of us with possible Lyme skin manifestations could get accurate biopsies to check for Lyme via this testing.
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