Spirochetal Forms in the Dermal Lesions of Morphea and Lichen Sclerosus et Atrophicus

Morphoea is neither associated with features of Borrelia burgdorferi infection, nor is this agent detectable in lesional skin by polymerase chain reaction

“… 1 In the following years, serological, immunohistochemical and culture approaches were performed to determine the role of Borrelia burgdorferi in the pathogenesis of morphoea. 2–5 However, conflicting results were obtained. Since 1993, several authors have used the polymerase chain reaction (PCR) to detect B. burgdorferi in lesional skin of patients with morphoea, but the relationship between morphoea and this organism has remained controversial.…”

Morphoea and Borrelia burgdorferi: results from the Scottish Highlands in the context of the world literature

“…This is particularly so for one group of Austrian researchers who have consistently found positive titres for B burgdorferi in a significantly higher proportion of patients with morphoea than in controls, and who have successfully demonstrated B burgdorferi in biopsies of morpheoic skin by immunoperoxidase with specific antibodies, in addition to the use of culture and typing. [14][15][16][17][18][19][20] If the positive results are taken at face value then an alternative 21 Germany ND 0/5 ND 9/9 Wienecke et al (1995) 22 Germany ND 4/18 ND 0/30 Weide et al (2000) 23 Germany ND 3/53 ND 0/33 Weber et al (1988) 24 Germany ND 0/2 2/2 ND Muhlemann et al (1986) 8 UK ND 0/22 ND ND Lupoli et al (1991) 9 UK ND 0/31 0/9 ND Raguin et al (1992) 25 France 0/14 (immunoperoxidase) 0/15 0/10 ND Meiss et al (1993) 26 Holland ND 0/12 0/12 0/12 Ranki et al (1994) 27 Finland ND 1/7 ND 0/7 Alonso-Llamazares et al (1997) 28 Spain ND 1/9 0/6 0/6 Trevisan et al (1996) 29 Italy ND 3/10 ND 6/10 Buechner et al (1993) 30 Switzerland ND 10/10 § ND ND Ozkan et al (2000) 31 Turkey ND ND ND 2/5 Ross et al (1990) 32 Puerto 33 USA 0/10 (silver stain) 0/3 ND ND Fan et al (1995) 34 USA ND ND ND 0/30 Dillon et al (1995) 35 USA ND ND ND 0/20 De Vito et al (1996) 36 USA ND ND ND 0/28 Colome-Grimmer et al (1997) 37 USA ND ND ND 0/10 *Eleven of 39 cases in this study also showed an increased B burgdorferi induced proliferation of peripheral blood lymphocytes. †This represents the only positive culture where spirochaetes have been subtyped; in this instance PCR analysis confirmed B afzelii.…”

Methodological Aspects

“…Borreliae were detected immunohistochemically in skin sections of lesions (5,147). Specific DNA could be amplified from 6 of 6 and from 3 of 3 skin biopsy specimens (151,175) and from 13 of 19 urine specimens (4) from infected patients.…”