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This lesion began two months after a tick bite on the left breast, occurring during a trip in Karst (highland behind the city of Trieste). This area represents an ecological shell for Ixodes ricinus, hard tick often infested with Borrelia burgdorferi, the aetiological agent of
Lyme disease. Some days after tick-bite, the patient developed a typical ECM of the left breast; this lesion resolved in two months. Shortly after, an erythematous, infiltrated nodule appeared on the left areola; ist size was about two cm. Histological diagnosis confirmed that the lesion was a LABC; the lymphocytic infiltrate consisted in a large number of B cell (detected with monoclonal antibodies). Indirect immunofluorescence for Borrelia burgdorferi (after absorption with Treponema phagedenis) was positive (titre 1/128-IgG). The lesion was treated with doxycycline, 200 mg/day per os for two weeks. The lesion cleared up three months after the end of therapy. Till today (two year thereafter), the patient didn’t present with local or general signs of
Lyme borreliosis; furthermore the serological test for Borrelia burgdorferi became negative.