Data_Sheet_1_Case report of disseminated borrelial lymphocytoma with isolation of Borrelia burgdorferi sensu stricto in chronic lymphatic leukemia stage Binet A—an 11 year follow up.pdf

We report a rare manifestation of cutaneous borreliosis in a patient with pre-existing malignant lymphoproliferative disease, in particular chronic lymphocytic B cell leukemia (B-CLL). The patient’s cutaneous lesions were initially diagnosed histologically as leukemia cutis. Distribution pattern of the skin lesions were in typical localizations for borrelial lymphocytoma. Borrelia burgdorferi sensu stricto was isolated and cultured from two sites (ear, mammilla). Antibiotic therapy improved the cutaneous lesions and the general condition of the patient. However, a second round of antibiotic therapy was required to resolve the lesions. At eleven years of follow-up the patient’s skin was clear and she still had a stable condition of B-CLL without chemotherapy. In conclusion, the patient suffered from Lyme borreliosis (Borrelia lymphocytoma) and the cutaneous symptoms were aggravated by the underlying condition of chronic B-CLL condition.本研究报告1例合并既往恶性淋巴增殖性疾病（尤以慢性B淋巴细胞白血病（B-CLL）为著）的皮肤疏螺旋体病罕见表现病例。该患者的皮肤损害最初经组织病理学诊断为皮肤白血病，其皮肤损害的分布模式符合疏螺旋体淋巴细胞瘤的典型好发部位。研究从两处部位（耳部、乳头）分离并培养出狭义伯氏疏螺旋体（Borrelia burgdorferi sensu stricto）。抗生素治疗后患者的皮肤损害及全身状况均有所改善，但需进行第二轮抗生素治疗方可完全消退皮损。随访11年后，患者皮肤已无异常，且未接受化疗的情况下慢性B淋巴细胞白血病病情仍保持稳定。总结而言，该患者罹患莱姆疏螺旋体病（疏螺旋体淋巴细胞瘤），其皮肤症状因合并的慢性B淋巴细胞白血病病情而有所加重。