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Differential Diagnosis:

Drug Eruption

Mycosis Fungoides

Perivascular or lichenoid

Lichenoid or psoriasiform-lichenoid

infiltrate

infiltrate

Eosinophils in the infiltrate

Lymphocytes monopolize

Vacuolar alteration, necrotic

Lymphocytes in the epidermis

keratinocytes

accompanied by subtle spongiosis

No changes of collagen

Wiry bundles of collagen

Focal parakeratosis

Elongated mounds of parakeratosis

Pathophysiology:

■ Erythema migrans is caused by species of Borrelia burgdorferi (Borrelia burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii)

References:

1. Afzelius A. Erythema chronicum migrans. Act Derm Venereol 1921; 2:120-125.

2. Berger BW, Clemmensen OJ, Gottlieb GJ. Spirochetes in lesions of erythema chronicum migrans. Am J Dermatopathol 1982; 4: 555-556.

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