Dr. Sandhya Narayanan Kutty
Venereology
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Patient's Query
Hello doctor,
Today I noticed a rash on my frontal shoulder. It is not bumpy, does not itch, or is painful to touch. However, the pain is with sudden shoulder movements and clavicle protraction. I would describe it as a pulling or oppressive pain. The pain is not severe but occurs in a very mild form for a few weeks. The rash is new, and I only noticed it today. I do not have a fever, but I was feeling tired two weeks ago. One month ago, I had erythema migrans, treated with Doxycycline 200 mg for ten days. Can this be something like neuroborreliosis, or do I have some other issue? Do I have to be concerned about it, or is it a common rash?
Kindly help.
Hello,
Welcome to icliniq.com.
Thank you for your query.
Neuroborreliosis may be an after effect of erythema migrans which is most often caused due to Lyme's disease. It is a condition that affects the joints, and the central nervous system, including the brain and spinal cord, and is represented by rashes, but mainly fever, headache, joint pain, and chills. Since you do not have any of these symptoms, they may not be neuroborreliosis.
However, you mentioned mild pain while moving joints, which is not usually common with other rashes. Even though they are mild pain due to the history of erythema migrans, we should not rule out the possibility of complications of erythema migrans. Therefore, my advice would be to consult a doctor in person to undergo investigations to rule out the possibility of neuroborreliosis which includes CBC (complete blood count), blood culture and sensitivity, CSF (cerebrospinal fluid) is tested for culture and sensitivity to rule out the presence of bacterial, viral or fungal infections.
Kindly check for fever, headache, chills, and joint pains.
I hope this has helped you. Thank you.
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Venereology
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