Six days ago, he developed an erythematous papule on the left abdomen.
Over the past week, this has grown into an oval 10 centimeter pruritic erythematous plaque.
This is a solitary lesion and the remainder of the cutaneous exam is unremarkable.
There is no history of tick bite, but this is an endemic area and the patient has an outdoor life-style.
I suspect this is Lyme Disease and that it is too early for serology to be helpful.
After discussion with the patient, he was started on doxycycline 100 mg bid.
(For interest, please see case of June 20th)
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