Dermatological and Genital Manifestations of Lyme Disease Including Morgellons Disease

Authors Middelveen MJ, Haggblad JS, Lewis J, Robichaud GA, Martinez RM, Shah JS, Du Cruz I, Fesler MC, Stricker RB

Received 5 January 2021

Accepted for publication 9 April 2021

Published 6 May 2021 Volume 2021:14 Pages 425—436


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Abstract: Although the erythema migrans (EM) skin rash is traditionally considered a hallmark of Lyme disease, other dermatological manifestations of the tickborne disease are less well known. We describe a 49-year-old woman with erosive genital ulcerations, secondary EM rashes and jagged skin lesions associated with Lyme disease. The skin rashes exhibited fibers characteristic of Morgellons disease. Molecular testing confirmed the presence of Borrelia DNA in both vaginal culture and serum specimens. In further studies on a secondary EM lesion containing filaments, Gömöri trichrome staining revealed the presence of collagen in the filaments, while Dieterle and anti-Borrelia immunostaining revealed intracellular and extracellular Borrelia organisms. Intracellular staining for Borrelia was also observed in lymphocytic infiltrates. Lyme disease may present with a variety of genital lesions and dermatological manifestations including Morgellons disease. Careful evaluation is required to determine the presence of Borreliaorganisms associated with these dermopathies.



Morgellons patients in many ways suffer worse than Lyme patients.  Most doctors still believe Morgellons is a figment of the imagination, while Lyme is getting some air-time and recognition – which unfortunately, doesn’t mean things are changing for the better.

This new case study is reminiscent of previous work done by some of the same study researchers:

  •  This 57-year-old woman previously diagnosed with Lyme disease had a painful erosive genital lesion. At the time of the outbreak, she was being treated with oral antibiotics, and she tested serologically positive for B burgdorferi and serologically negative for syphilis. Dieterle-stained biopsy sections revealed visible spirochetes throughout the stratum spinosum and stratum basale, and anti-B burgdorferi immunostaining was positive. Motile spirochetes were observed by darkfield microscopy and cultured in Barbour-Stoner-Kelly-complete medium inoculated with skin scrapings from the lesion. Cultured spirochetes were identified genetically as B burgdorferi sensu stricto by polymerase chain reaction, while polymerase chain reaction amplification of treponemal gene targets was negative. The condition resolved after treatment with additional systemic antibiotic therapy and topical antibiotics. 
  •  Culture and identification of Borrelia spirochetes in human vaginal and seminal secretions.  This study has gone through 3 versions dating from December, 2014-April 2015.  Only 2 of 4 reviewers approved it.  Results:  Control subjects who were asymptomatic and seronegative for Bb had no detectable spirochetes in genital secretions by PCR analysis. In contrast, spirochetes were observed in cultures of genital secretions from 11 of 13 subjects diagnosed with Lyme disease, and motile spirochetes were detected in genital culture concentrates from 12 of 13 Lyme disease patients using light and darkfield microscopy. Morphological features of spirochetes were confirmed by Dieterle silver staining and immunohistochemical staining of culture concentrates. Molecular hybridization and PCR testing confirmed that the spirochetes isolated from semen and vaginal secretions were strains of Borrelia, and all cultures were negative for treponemal spirochetes. PCR sequencing of cultured spirochetes from three couples having unprotected sex indicated that two couples had identical strains of Bb sensu stricto in their semen and vaginal secretions, while the third couple had identical strains of B. hermsii detected in their genital secretions.  Conclusions: The culture of viable Borrelia spirochetes in genital secretions suggests that Lyme disease could be transmitted by intimate contact from person to person. Further studies are needed to evaluate this hypothesis.  
  • Lida Mattman has isolated Bb from many sources, including semen, urine, blood, plasma, and CSF:
  • Lyme advocate Carl Tuttle points out that 45 lab acquired infections with Borrelia burgdorferi are on record, all of which were NOT vector-borne (didn’t come from a tick bite). How did these workers get infected?

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