INFLUENCE OF LYME BORRELIOSIS ON THE COURSE OF URTICARIA

Abstract

SUMMARY. The aim – to establish the clinical features of urticaria in patients with Lyme borreliosis.

Material and Methods. 55 patients with urticaria were under observation during 2019–2022. They were treated as outpatients and inpatients at the "Starokostyantinivska TsRP" KNP and Ternopil Regional Clinical Dermatological and Venereological Dispensary. The age of the patients ranged from 18 to 71 years. There were 19 (34.5 %) men, 36 (65.5 %) women.

Specific antibodies to antigens of the B. burgdorferi s. l. in the blood sera of all examinees were determined by the ELISA method, using the test system of the company Euroimmun AG (Germany). The results obtained were evaluated as positive, intermediate or negative and interpreted according to the manufacturer’s recommendations.

The Urticaria activity score (UAS7) was used to assess the activity of urticaria, which is based on the assessment of the main signs and symptoms of urticaria (blisters and itching), where 0 points mean the absence of blisters and itching; 1 point – itching is slightly expressed (present, but not bothersome and does not cause trouble), rash is slightly expressed (less than 20 blisters/24 hours); 2 points – moderately expressed itching (causes trouble, but dloes not interfere with normal daily activity or sleep), moderately expressed rash (presence of 21–50 blisters/24 hours); 3 points – intense (pronounced itching that causes a lot of inconvenience and interferes with normal daily activity and sleep), the rash is significantly expressed (>50 blisters/24h). Accordingly, the interpretation of severity of exacerbation is as follows: 0–2 points – mild exacerbation, 3–4 points – moderate severity, 5–6 points – severe exacerbation.

Results. Depending on the presence of laboratory-confirmed concomitant Lyme borreliosis in patients with urticaria, they were divided into two groups: group 1 – 27 patients with urticaria with LB and group 2 – 28 patients with urticaria without LB.

The next trigger factors for the occurrence of urticaria were established: in 20.0 % – food products, in 10.9 % – medicines, in other 69.1 % of cases, the disease was considered idiopathic. Patients with urticaria associated with Lyme disease were significantly more likely to be bothered by headache, joint pain and swelling, muscle pain, fatigue/general weakness, p<0.05. A predominance of significantly pronounced rash (>50 blisters/24h) and severe itching, which causes a lot of discomfort and interferes with normal daily activity and sleep, was established in patients with urticaria combined with Lyme borreliosis compared to the group patients with urticaria without this tick infection: 25.9 % vs. 3.6 %, p<0.05 and 51.9 % vs. 14.3 %, p<0.05, respectively.

Conclusions. Headache, joint pain and swelling, muscle pain, fatigue/general weakness and a significantly pronounced rash (>50 blisters/24h) prevailed and severe itching that causes a lot of discomfort and interferes with normal daily activities and sleep were significantly more likely to bother patients with urticaria in LB.