Can the erythema migrans rash of Lyme disease be itchy?

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Last updated: November 9, 2026 • View editorial policy

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Jah, borrelioosi erüteem migrans võib sügeleda

Erythema migrans võib olla sügelev, kuigi sügelus on tavaliselt kerge. Sügelus ei ole peamine sümptom, kuid see on tunnustatud kliiniline tunnus, mis ei välista diagnoosi 1.

Kliinilised tunnused

Erythema migrans'i puhul tuleb arvestada järgmiste omadustega:

  • Sügelus või valu võivad esineda, kuid need kaebused on üldiselt kerged 1
  • Lööve võib olla ka soe puudutamisel 2
  • Paljud patsiendid kirjeldavad löövet kui mittesügelevat, kuid sügelus ei välista diagnoosi

Peamised diagnostilised punktid

Erythema migrans'i äratundmisel keskenduge järgmistele:

  • Lööve ilmub 7-10 päeva pärast puugi hammustust (vahemik: mõni päev kuni 1 kuu) 1
  • Läbimõõt suureneb aja jooksul
  • Keskne tühjenemisala võib puududa >50% patsientidest 1
  • Lokalisatsioon: tavaliselt kaenlaalune, kubemepiirkond, küünarnukk või vöökoht 2

Oluline hoiatus

Sügeluse puudumine EI välista borrelioosi diagnoosi. Paljud klassikalised erythema migrans'i juhtumid ei ole sügelevad. Samuti võib sügelus olla nii kerge, et patsient ei pruugi seda isegi mainida.

Diferentsiaaldiagnostika

Sügeleva ringikujulise lööbe puhul kaaluge ka:

  • Seeninfektsioon (tinea)
  • Artropoodi hammustuse ülitundlikkusreaktsioon
  • Streptokokk-/stafülokokk-tselluliit
  • Granuloma annulare

Kuid endeemilises piirkonnas puugi kokkupuute anamneesiga on kliiniline diagnoos piisav ilma laboratoorsete testideta 3.

Ravi

Kui erythema migrans on diagnoositud (sügelev või mitte):

  • Doksütsükliin 10 päeva või
  • Amoksitsilliin või tsefuroksiimaketsiil 14 päeva 3

Ravi ei sõltu sügeluse olemasolust või puudumisest.

References

1
Research

Erythema migrans and early Lyme disease.

The American journal of medicine, 1995

2
Research

Skin Changes in Suspected Lyme Disease.

Acta dermatovenerologica Croatica : ADC, 2023

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