1. Lyme Disease Rash vs. Other Rashes


Lyme Disease Rash vs. Other Rashes

Lyme disease diagnoses have been steadily increasing in the United States at alarming rates, especially the Maryland, DC, and Virginia area.

Below is a map from the Centers for Disease Control (CDC) which shows reported cases of Lyme Disease in 2001 and 2014.

Reported cases of Lyme Disease US 2001 Reported cases of Lyme Disease US 2014

The trademark rash of Lyme disease is often described as a “bull's-eye” with a round red rash that is dark in the center, and has dark outer edges.

It is formally called Erythema Chronicum Migrans or Erythema Migrans. This rash indicates the early stage of Lyme disease. Because of its growing awareness, many rashes are often mistaken for Lyme disease. Below are a few examples of Lyme disease rashes compared to other common rashes.


1.  Erythema Migrans vs. Ringworm

Lyme Disease Rash 1B


To the left is how a Lyme disease rash, Erythema Migrans, usually appears with the trademark circular “bull's-eye” center.

Ringworm is described as a circular rash that often has raised edges. Ringworm is caused by a fungus while Lyme disease is caused by the bacteria Borrelia burgdorferi.


2.  Erythema Migrans vs. an Insect Bite Allergic Reaction

Lyme Disease Rash 2A Lyme Disease Rash 2B


This version of Erythema Migrans on the left is slightly different than the characterized “bull's-eye” rash.

It is a spread out rash with a scab in the center.

The insect bite allergic reaction on the right does look similar, but it was described as itchy. Erythema Migrans is mostly described as not itchy or painful, but warm to the touch.


3. Erythema Migrans vs. a Drug Allergic Reaction

Lyme Disease Rash 3A


The Erythema Migrans rash is usually five to seven centimeters wide, and appears in 4 different forms, the “bull's-eye” being the most popular.

The Erythema Migrans rash pictured to the left appears to be several rashes with lighter centers. The picture to the right is a skin condition that occurs after taking certain medications.

The bruise-like rash often reoccurs in the same spot when the medication is taken.


4.  Erythema Migrans vs. a Granuloma Annulare Rash

Lyme Disease Rash 4A Lyme Disease Rash 4B


This Erythema Migrans rash on the left looks similar to ringworm, but it is an early indication of Lyme disease.

To the right is an example of Granuloma Annulare. It is a rare, chronic skin condition where bumps appear in a circle or a ring. It occurs at any age, but it is more prevalent in females, occurring at an 80 to 20 ratio.

It is seen in healthy people, and also in people with suffering from certain types of lupus, arthritis and thyroid disease. However, there is no current information that links healthy people to others suffering from Granuloma Annulare.


5.  Erythema Migrans vs. Urticaria multiforme
Lyme Disease Rash 5A Lyme Disease Rash 5B


This last Erythema Migrans rash on the left is described as a red, oval-shaped rash.

To the right is a condition known as Urticaria multiforme. It is a benign skin reaction seen in pediatric patients that is characterized by light, spread out rashes with lighter centers.

The condition is primarily caused by an interior infection of the body's immune system. 


Quick Facts


  • Not all people bitten by ticks infected with the causing agent of Lyme disease develop Erythema Migrans
  • Many people who develop Erythema Migrans don’t recall getting bitten by a tick
  • Not all Erythema Migrans rashes are caused by ticks carrying Lyme disease. The Lone star tick is known to cause a rash when it bites people. This is called Southern tick-associated rash illness or STARI and it has been concluded that this rash is not caused by Lyme disease-causing bacterium Borrelia burgdorferi.
  • Maryland is on the top 10 list for new cases of Lyme Disease as of 2015.
  • In 2005, Virginia had 274 new confirmed cases of Lyme disease, in 2014, Virginia had 976 cases, in 2016, 976 cases were confirmed.
  • In 2005, Maryland had 1235 new confirmed cases of Lyme disease, in 2014, Maryland had 957 cases, in 2016, 1274 cases were confirmed.
  • In 2005, DC had 10 confirmed cases of Lyme disease, in 2014, DC had 35 cases, in 2016, 66 cases were confirmed.


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