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Robert R. Muellegger, MD; Natalie Zoechling, MD; H. Peter Soyer, MD; Stefan Hoedl, MD; Ralf Wienecke, MD; Matthias Volkenandt, MD; Helmut Kerl, MD

Arch Dermatol. 1995;131(6):678-682.

Abstract
Background and Design
Early treatment of erythema migrans is important to prevent late complications. Minocycline possesses several attributes, making it potentially useful in the treatment of borrelial infections. In our study, minocycline was administered to 14 patients with erythema migrans. Punch biopsy specimens were obtained from the (affected) skin of all patients before and after therapy. The formalin-fixed, paraffin-embedded specimens were analyzed by polymerase chain reaction for the presence of Borrelia burgdorferi— specific DNA.

Results
Polymerase chain reaction assay succeeded in amplifying B burgdorferi—specific DNA from the first biopsy specimen, obtained from the border of erythema migrans before initiating treatment, in eight (57%) of 14 patients. At the end of minocycline therapy, however, polymerase chain reaction analysis disclosed no B burgdorferi—specific DNA in any of the 14 patients. The good clinical response of our patients with erythema migrans substantiates our molecular findings.

Conclusions
The presented polymerase chain reaction data, together with the clinical outcome, indicate that minocycline may be useful for treatment of early Lyme borreliosis.

(Arch Dermatol. 1995;131:678-682)

Author Affiliations
From the Department of Dermatology, Karl-Franzens University, Graz, Austria (Drs Muellegger, Zoechling, Soyer, Hoedl, and Kerl), and the Department of Dermatology, Ludwig-Maximilians University, Munich, Germany (Drs Wienecke and Volkenandt).

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