No Evidence for a Relation Between Borrelia burgdorferi Infection and Old Lesions of Localized Scleroderma (Morphea)

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Abstract
To the Editor.— Dermatologic manifestations of Lyme disease include erythema chronicum migrans, lymphadenosis benigna cutis, and acrodermatitis chronica athrophicans (ACA). Another dermatologic eruption, localized scleroderma (morphea), has been associated with Lyme borreliosis on the basis of serologic evidence.1,2 However, other investigators3,4 could not confirm this association using similar techniques. Skin lesions in seropositive individuals previously reported to be Borrelia burgdorferi-associated morphea may have represented an atypical sclerodermic form of ACA. To provide additional evidence of a spirochetal origin of localized sclerodema, we have studied skin biopsy specimens from 12 patients, with clinical and pathologic evidence of morphea, for the presence of B burgdorferi by means of histologic tests, culture, and polymerase chain reaction (PCR).5 All 12 patients (10 women and two men) had the disease for at least 3 years (maximum, 21 years) (Table). None of the patients had a history suggesting Lyme disease (tick bite

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