One manifestation of early Lyme disease is a cutaneous pseudolymphoma.
Clinical features:
(1) diffuse erythematous cutaneous plaque or nodule
(2) preferential sites include ear, scrotum, foot, face or areola
The patient may not give a history of tick bite.
Erythema migrans may or may not be present.
Other signs of Lyme disease may or may not be present.
Biopsy findings:
(1) lymphoplasmacytic infiltrate in the dermis
(2) mixed B and T cell infiltrate
The diagnosis is aided by positive serologic testing for Borrelia species (B. burgdorferi in the US).
With appropriate antibiotic therapy the lesion disappears
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Specialty: Infectious Diseases
