Author Credentials

James Clayton Curry, MS4 Joan C. Edwards School of Medicine at Marshall University Curry162@marshall.edu Shane E. Cook, MD Boone Memorial Hospital Drcook.se@gmail.com

Author ORCID Identifier



Lyme Disease, erythema migrans, Borrelia burgdorferi


Dermatology | Infectious Disease | Medicine and Health Sciences


Lyme disease is a systemic infection caused by the spirochete Borrelia burgdorferi often carried the Ixodes tick. It is associated with dermatologic manifestations, most notably the “bullseye rash” of erythema migrans. The disease can progress in stages to involve other organs such as joints, heart, and the nervous system. Lyme disease is continuing to spread, with West Virginia cases increasing dramatically in the last 2 decades. As a result, physicians are likely to encounter this disease more often, making recognition and early treatment a top priority in order to prevent potentially dangerous sequelae. We present a case of a 60-year-old man who presented with multiple erythematous annular plaques and was subsequently diagnosed with Lyme disease. He had no known exposure to ticks, was treated for Lyme Disease, and subsequently developed a Jarisch- Herxheimer reaction (JHR).