A 2-year-old girl presented with a reddish swelling of the left earlobe which had been present for over 6 months. Because of the unspecific previous medical history and the unclear clinical symptoms a biopsy of the swelling was carried out. The histological investigation revealed a lymphocyte-infested infiltration with lymph follicles corresponding to cutaneous lymphoid hyperplasia, which is a rare but typical skin manifestation of stage II
Lyme borreliosis. The infection could be successfully treated with antibiotics.