Polymerase Chain Reaction of Borrelia burgdorferi Flagellin Gene in Shulman SyndromeHashimoto Y.a · Takahashi H.a · Matsuo S.a · Hirai K.b · Takemori N.b · Nakao M.c · Miyamoto K.c · lizuka H.a
Departments of aDermatology, bInternal Medicine and cParasitology, Asahikawa Medical College, Asahikawa, Japan
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A 49-year-old man presented a progressive swelling and induration of the skin resulting in flexion contracture. He had a history of two tick bites at the age of 17 and 47 years. Serum anti-Borrelia-burgdorferi antibody was positive; isolation of B. burgdorferi from the skin lesion was unsuccessful. He had eosinophilia (white blood cells 8,300/μl, 33% eosinophils) and hypergammaglobulinemia. The diagnosis of Shulman syndrome (eosinophilic fasciitis) from clinical and histological findings was established. A part of the flagellin gene of B. burgdorferi was detected in a skin biopsy sample by using the polymerase chain reaction method. To the best of our knowledge, this is the first report of detection of B.-burgdorferi-specific DNA from a skin sample of Shulman syndrome.
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