Identification of Three Species of Borrelia burgdorferi Sensu Lato (B. burgdorferi Sensu Stricto, B. garinii, and B. afzelii) Among Isolates from Acrodermatitis Chronica Atrophicans Lesions

Abstract

In Europe, at least three species of Borrelia are known to be causative agents of Lyme borreliosis: B. burgdorferi sensu stricto, B. garinii, and B. afzelii. Observable differences in the molecular characteristics of the three species have led to speculation that they may also differ in their pathogenic potential and/or tissue tropisms. Several studies have found an association between the chronic skin manifestation of Lyme borreliosis, acrodermatitis chronica atrophicans, and infection by B. afzelii. We sought to find further evidence for such a correlation by studying the genetic profiles of 22 strains of B. burgdorferi sensu lato derived from 21 patients who presented to the University Medical Center, Ljubljana, Slovenia between 1992 and 1995. Strains were isolated in culture from skin biopsies of acrodermatitis chronica atrophicans lesions; in the case of one patient two separate acrodermatitis chronica atrophicans lesions were cultured. All 21 patients had clinically typical lesions with "classic" histopathology and high IgG antibody titers to B. burgdorferi sensu lato. Strains were characterized and typed by 16S ribosomal RNA-specific polymerase chain reaction and determination of their large restriction fragment patterns using pulsed-field gel electrophoresis of MluI-digested genomic DNA. Of the 22 isolates studied, 17 possessed the highly conserved MLa1 pattern characteristic of B. afzelii. The remaining five isolates possessed large restriction fragment patterns that were typical of B. garinii (MLg2, four isolates from three patients) and B. burgdorferi sensu stricto (MLb2, one isolate). The results of 16S ribosomal RNA-specific polymerase chain reaction were concordant with these species designations. These data show that B. afzelii is the predominant, but not the exclusive, etiologic agent of acrodermatitis chronica atrophicans.

The origin of tendon friction rubs in patients with systemic sclerosis: A sonographic explanation

“…Acrodermatitis chronica atrophicans is the most typical indicator of late Lyme borreliosis. The usual causative agent is B afzelii, a Borrelia species found in Europe but not in North America (1). Acrodermatitis chronica atrophicans typically manifests first with inflammation and second with an atrophic stage, when the skin becomes thin, wrinkly, and translucent (2).…”

“…Tendon friction rubs have been ascribed to fibrin deposition in the tendon's synovial sheath (1). This assumption, however, does not account for tendon friction rubs that are palpable at tendons that are devoid of a sheath, such as the Achilles, patellar, and finger extensor tendons.…”

“…The origin of tendon friction rubs in patients with systemic sclerosis: a sonographic explanation Palpable tendon friction rubs constitute a distinct sign in patients with systemic sclerosis (SSc), particularly in those with diffuse cutaneous involvement (dcSSc) (52%) (1). Tendon friction rubs have been ascribed to fibrin deposition in the tendon's synovial sheath (1).…”

Prevalence of <i>Borrelia burgdorferi</i> in ticks removed from skin of people and circumstances of being bitten – research from the area of Poland, 2012–2014

“…In North America there is one major genospecies -Borrelia burgdorferi sensu stricto [16]. These genospecies colonize different organs, due to which the symptoms of the disease may vary considerably in patients from both continents [30][31][32]. In Europe, Lyme disease most commonly affects the nervous system, whereas in North America joint symptoms prevail.…”

Characterization of Lyme Borreliosis Isolates from Patients with Erythema Migrans and Neuroborreliosis in Southern Sweden

“…The agents of LB are divided into eight serotypes based on their reactivity to OspA monoclonal antibodies (MAbs) (47,48). Furthermore, clinical data suggest an association between infecting Borrelia species and clinical manifestations in Europe (4,5,16,17,21,22,27,39,40,44). B. burgdorferi sensu stricto is the most common spirochete species associated with Lyme arthritis, and B. afzelii predominates in the skin, especially in cases of acrodermatitis chronica atrophicans (ACA) (39).…”