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Tick Bite–Associated Morphea

A Case Report

George, Eva MD; Nielson, Colton B. MD; Vincek, Vladimir MD, PhD

The American Journal of Dermatopathology: October 2019 - Volume 41 - Issue 10 - p 747–749
doi: 10.1097/DAD.0000000000001290
Controversies in Dermatopathology

Abstract: Borrelia burgdorferi, the causative organism of Lyme disease, has been linked to the development of scleroatrophic skin conditions including morphea, although this association remains controversial. The possibility that tick bite with or without concurrent Borrelia infection instigates that morphea development is important to recognize because this could prompt further workup for Lyme disease, or other tick-borne illness, which, when untreated, can have devastating consequences. Here, we report a case of a woman with a history of previous tick bite in the location of morphea. This prompted further workup, including serologies that were negative for borrelia. The patient declined empiric treatment with doxycycline. It is important to be aware that morphea may represent a consequence of tick bite because this can alter patient management.

Department of Dermatology, University of Florida College of Medicine, Gainesville, FL.

Correspondence: Vladimir Vincek, MD, PhD, Department of Dermatology, University of Florida College of Medicine, 4037 NW 86 Terrace, 4th floor Springhill 4119, Gainesville, FL 32606 (e-mail:

The authors declare no conflicts of interest.

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