An Internet Survey of Identification of Erythema Migrans

Topics with information and discussion about published studies related to Lyme disease and other tick-borne diseases.
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panda
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An Internet Survey of Identification of Erythema Migrans

Post by panda » Sun 11 Nov 2012 15:11

Dermatol Res Pract. 2012;2012:451727. doi: 10.1155/2012/451727. Epub 2012 Oct 24.
Bull's-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans.
Aucott JN, Crowder LA, Yedlin V, Kortte KB.
Department of Medicine, Johns Hopkins University, 10755 Falls Road, Suite 200, Lutherville, MD 21093, USA.
Abstract
Introduction. Lyme disease is an emerging worldwide infectious disease with major foci of endemicity in North America and regions of temperate Eurasia. The erythema migrans rash associated with early infection is found in approximately 80% of patients and can have a range of appearances including the classic target bull's-eye lesion and nontarget appearing lesions.
Methods. A survey was designed to assess the ability of the general public to distinguish various appearances of erythema migrans from non-Lyme rashes. Participants were solicited from individuals who visited an educational website about Lyme disease.
Results. Of 3,104 people who accessed a rash identification survey, 72.7% of participants correctly identified the classic target erythema migrans commonly associated with Lyme disease. A mean of 20.5% of participants was able to correctly identify the four nonclassic erythema migrans. 24.2% of participants incorrectly identified a tick bite reaction in the skin as erythema migrans.
Conclusions. Participants were most familiar with the classic target erythema migrans of Lyme disease but were unlikely to correctly identify the nonclassic erythema migrans. These results identify an opportunity for educational intervention to improve early recognition of Lyme disease and to increase the patient's appropriate use of medical services for early Lyme disease diagnosis.
http://www.ncbi.nlm.nih.gov/pubmed/23133445 [abstract]

http://www.hindawi.com/journals/drp/2012/451727/ [full text]

Cobwebby
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Re: An Internet Survey of Identification of Erythema Migrans

Post by Cobwebby » Mon 12 Nov 2012 0:03

Conclusions. Participants were most familiar with the classic target erythema migrans of Lyme disease but were unlikely to correctly identify the nonclassic erythema migrans.
Yeah- wonder how many docs are capable of correctly identifying the nonclassic EM?
The greater part of our happiness or misery
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and not on our circumstances.
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panda
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Re: An Internet Survey of Identification of Erythema Migrans

Post by panda » Mon 12 Nov 2012 1:59

Aucott et al. 2012:
Additionally, a study showed that up to 72% of physicians surveyed are not able to correctly identify the EM accompanying LD [14] when shown both EM as well as other rashes common in an ambulatory population.

14: D. Lipsker, A. Lieber-Mbomeyo,G. Hedelin,
How accurate is a clinical diagnosis of erythema chronicum migrans? Prospective study comparing the diagnostic accuracy of general practitioners and dermatologists in an area where lyme borreliosis is endemic,
Archives of Dermatology, vol. 140, no. 5, pp. 620–621, 2004.

http://archderm.jamanetwork.com/article ... eid=480480 [exstract with figures]
Lyme borreliosis is a worldwide tick-borne zoonosis caused by infection with Borrelia burgdorferi, a spirochete. Erythema chronicum migrans (ECM) is the most common and most specific clinical sign of Lyme borreliosis, and it is a defining criterion for Lyme disease in North America and Europe.[1-2] Most patients with ECM do not exhibit any seroreactivity against B burgdorferi.[3] Diagnosis relies solely on the clinical recognition of ECM. Therefore, physicians must be able to identify ECM correctly and to differentiate it from other similar erythematous dermatoses. The unique aim of the present study was to evaluate the ability of general practitioners (GPs) and dermatologists to identify ECM in Strasbourg, a city in the eastern part of France and a region in which Lyme borreliosis is highly endemic.[4]
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Panda

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