Erythema Migrans (Lyme Disease) and Erythema Infectiosum (Fifth Disease)

by Carlo Raj, MD

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    00:01 Here we have erythema migrans.

    00:03 We want to make sure that you take a second and you take a look at this picture and it’s like you’re taking a dart and you’re practicing -- dartboard.

    00:14 In other words, you’re going after the target.

    00:17 This is a target lesion.

    00:20 What happened? If you go right – Take a look at this a little bit closer.

    00:22 I want you to go into the middle of the target.

    00:25 That’s where the Ixodes tick burrowed, right? Deep inside.

    00:30 And when it did, it then elicited or introduced a bacteria or spirochete called Borrelia burgdorferi.

    00:37 Welcome to Lyme disease.

    00:39 All right, so erythema migrans or erythema chronicum migrans, we call it a target lesion.

    00:45 Pay attention to the description.

    00:47 You have a central area of erythema.

    00:50 Think about target.

    00:51 Surrounded by pallor.

    00:54 Then surrounded by a perimeter or ring of erythema.

    00:58 And the cycle continues.

    01:00 Target, target, target lesion.

    01:02 It may be associated with fever and/or arthralgia caused by Borrelia burgdorferi.

    01:07 The name of the tick is Ixodes.

    01:08 Remember with Lyme disease, you’re up in northeast U.S., you were hunting deer per se, and you end up developing or acquiring the tick and then the bacteria.

    01:19 Here’s my vector, the Ixodes scapularis.

    01:24 Management: Doxycycline.

    01:28 And we have fifth disease.

    01:29 This is erythema infectiosum.

    01:32 Make sure that you’re familiar with this.

    01:34 Fever, coryza.

    01:37 What ends up happening in terms of your history? It looks like there’s a slapped cheek.

    01:43 Fifth disease, think of it that way.

    01:44 Take your hand, which has five fingers, slap my cheek.

    01:49 Slapped cheek-like appearance.

    01:52 Lacy, reticular rash on extremity.

    01:54 Take a look at this patient here and you’ll notice on the back, it's a lacy type of reticular – What does reticular mean? Networking.

    02:03 Remember the reticular pattern that we saw on chest x-ray with interstitial lung disease? The same thing, but this time, we’re going to find this being erythematous.

    02:12 Now, the cause is -- memorize parvovirus B19, a single stranded DNA.

    02:19 No longer really infectious once the rash appears.

    02:23 Pregnant women exposed are at risk of hydrops fetalis, unfortunately.

    02:30 And may cause what’s known as your transient aplastic anemia.

    02:34 Why? Because if you’re dealing a parvovirus B19, there’s every possibility that there is shutting down of your bone marrow, resulting in a normocytic type of aplastic or non-hemolytic type of anemia.

    02:49 That, we’ll talked about plenty when we deal with parvovirus B19 with either sickle cell disease ands so forth.

    About the Lecture

    The lecture Erythema Migrans (Lyme Disease) and Erythema Infectiosum (Fifth Disease) by Carlo Raj, MD is from the course Infectious Skin Diseases. It contains the following chapters:

    • Erythema Migrans
    • Erythema Infectiosum

    Included Quiz Questions

    1. Human parvovirus B19
    2. Human papillomavirus
    3. Influenza virus
    4. Human herpesvirus 7
    5. Measles virus
    1. Borrelia burgdorferi
    2. Mycobacterium leprae
    3. Type I hypersensitivity
    4. Photosensitivity
    5. Tinea corporis
    1. Doxycycline
    2. Azithromycin
    3. Neomycin
    4. Corticosteroids
    5. Demeclocycline

    Author of lecture Erythema Migrans (Lyme Disease) and Erythema Infectiosum (Fifth Disease)

     Carlo Raj, MD

    Carlo Raj, MD

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