Suggest treatment for lesions on lower extremities
Tick borne skin lesion
Thank you for your query. I can understand your concerns.
Zoonotic infection which can spread from deer are mainly viral like Jamestown Canyon virus (JCV),Cache Valley virus (CVV),Tick-borne encephalitis virus
(TBEV).These can produce some rashes which usually subside but does not produce nodules or necrotic lesions as shown by the picture posted by you.
Lyme Borreliosis(spirochete ) transmitted by ticks of the Ixodes ricinus complex can somehow cause similar kind of lesions,as the center of skin lesion sometimes becomes intensely erythematous,and indurated, vesicular, or necrotic.
It would be appropriate to go for two-step approach in which samples are first tested by enzyme-linked immunosorbent assay (ELISA) and equivocal or positive results are then tested by western blotting. During the first weeks of infection, both IgM and IgG responses to the spirochete should be determined, preferably in both acute- and convalescent-phase serum
After 4–8 weeks of infection , the sensitivity and specificity of the IgG response to the spirochete -very high—in the range of 99%—as determined by the two-test approach of ELISA and western blot.Since you have been bitten in November 2015,it is fairly possible to have conclusive test by now.
Dr. T.K. Biswas M.D.
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