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Lyme disease is a tick-borne illness, which is typically caused by Borrelia Burgdoferi. Over time, a typical Borreliosis skin reaction takes shape, i.e. the formation of an annular erythema that tends to expand centrifugally with erythematous edges whose diameter can reach up to 20 cm. The symptoms of Lyme disease are not only cutaneous but there may be a systemic involvement. Obviously, this disease can also affect pregnant women and for this reason this review aims to summarize the main ways of treatment to avoid worsening of the clinical condition in the mother and an eventual, albeit rare, involvement of the fetus.

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.