Erythema migrans is a reddening of the skin, which often occurs in the first stage of the tick-borne disease Lyme borreliosis. Typically, the walking redness occurs a few days to weeks after a tick bite and spreads circular from the sting site.
However, it does not come in all cases of Lyme disease to a Wandererote. In addition, the appearance can be very different and is therefore often difficult to differentiate from other causes of redness. If rumination is suspected, a blood test for Lyme disease should be performed. If positive, treatment with an antibiotic may prevent progression of the disease.
Cause of Wanderröte
The wandering redness is caused by the bacterium Borrelia burgdorferi, which, like the TBE virus, is transmitted via the saliva of a tick to humans. For example, a tick bite can lead to infection with Borrelia and thus to Lyme disease.
Frequently, the disease begins with the onset of redness, however, a borreliosis without Wanderröte occurs in about 10 to 20 percent of cases.
What is Wandering Toad?
The classic wandering redness is a reddening of the skin, which spreads circularly around the puncture site after a tick bite. Frequently, this forms an annular fading, the tick bite is usually clearly visible in the middle.
Falsely, colloquially is often spoken of a tick bite, although ticks actually do not bite man, but sting.
Recognize Wandering Toad
Unlike a mosquito bite or brake bite, the walking toad is usually not swollen and much larger (usually over five inches in diameter). Pain and itching are rare, but the area of redness is often overheated.
In addition, flu-like symptoms may occur:
- Fever and chills
- a headache
- Tiredness and exhaustion
- Muscle and joint pain
- Swelling of the lymph nodes
- burning, watery eyes
Danger of confusion: Atypical wandering redness
The expression of the Wanderröte can be very different. A so-called atypical wandering red is not rare and can deviate significantly from the classic circular image.
Thus, the redness in atypical Wanderröte be intense and flat or only pale and stripe-shaped - even redness is distributed over the body are possible. The color can vary from light pink to intense red to bluish purple. In addition, wheals, blisters or nodules may occur in atypical wandering.
When does wandering heat occur?
The appearance and duration of the reddening can vary widely: usually the redness occurs 3 to 30 days after the tick bite. The duration of the mottling is influenced by the treatment - the sooner an antibiotic therapy is started, the sooner the redness stops.
Most of the duration is a few days to weeks, but the redness may persist for months - it is then called Chronic Wandering Red (Erythema chronicum migrans).
What looks similar to wandering red?
Because of the different appearance, the flare is often difficult to distinguish from other forms of redness. The following overview can help you to differentiate between possible causes:
- An insect bite itches in most cases, in addition, redness and swelling occur immediately after the stitch and clear after a few days.
- In a Wundrose (erysipelas) accompanying symptoms such as fever, fatigue and overheating of the skin are usually pronounced. In addition, there is often a swelling and pain.
- An allergic reaction to a drug (drug eruption) is also often associated with pain and itching. In addition, it is usually possible to establish a connection to the intake of a new drug - often an antibiotic is the cause.
- Inflammation of the hypodermis (hypodermitis), which may occur in connection with venous insufficiency, typically manifests itself as thickened and hardened redness, and often occurs symmetrically on both lower legs.
- Certain forms of the autoimmune disease scleroderma may manifest themselves as round, reddish skin symptoms. However, this is also a skin hardening typical.
- Herpes and shingles are usually associated with pain. In addition, it often comes after a few days to a blistering.
- Tinea corporis - a fungal disease of the skin - can cause itchy, red ring itching, which often flakes in the border area and pustules.
Diagnosis: Blood test not always necessary
If the doctor clearly recognizes a typical wandering color (visual diagnosis), this is proof of the presence of Lyme disease. Therefore, without further diagnostics, a treatment with antibiotics should be started - even if the patient can not remember a tick bite.
In unclear cases, various blood tests may be performed to diagnose or eliminate the pathogen as symptoms of Lyme disease. The blood is tested for antibodies to Borrelia. Rarely, a skin sample (biopsy) from the area of redness is taken in order to detect the pathogen directly.
Wanderröte: What helps?
Treatment is usually by the antibiotic doxycycline. However, the active ingredient should not be used in pregnancy and in children under the age of nine; alternatively, amoxicillin, more rarely cefuroxime or azithromycin, is usually used.
Because the pathogen is caused by bacteria, creams - such as cortisone - are ineffective.
Therapy: The sooner the better
The duration of the treatment is usually two to three weeks. If therapy is started early enough, the prognosis of the pathogen is very good: it can often prevent a chronic course or transition to advanced stages of Lyme disease.
To prevent mottling
A Borrelia vaccine currently does not exist. Protection against ticks is therefore the most important preventative measure. If there is still a tick bite, the tick should be removed as soon as possible (within the first 24 hours). The longer the tick is in the skin, the higher the risk of transmitting Borrelia.
Thereafter, the puncture site should be observed for six weeks to detect a wandering red at an early stage.
Antibiotic prophylaxis does not make sense
Although a prophylactic antibiotic treatment after a tick bite may possibly reduce the risk of Borrelia infection. However, the risk of developing Lyme disease is generally rather low: in just 0.3 to 1.4 percent, a tick bite leads to illness.
Because of possible side effects, therefore, preventive antibiotic use is not recommended.