Analysis of Lyme Disease Lesions

INCLUSION CRITERIA: Patients: Age greater than or equal to 18 years Diagnosis of EM - an expanding annular lesion, at least 5 cm in diameter on a person with a history of exposure to the disease. Exposure is defined as having been (less than or equal to 30 days before onset of EM) in wooded, brushy, or grassy areas (i.e., potential tick habitats) in an area in which Lyme disease is endemic. A history of tick bite is not required. The area of the erythema migrans lesion is suitable for biopsy. This excludes biopsies on the face, neck, scalp, and over the tibia. Not know to be positive for RPR, HIV, HBsAg or HCV Able to give consent Healthy Volunteers: Age greater than or equal to 18 years Not positive for RPR, HIV, HBsAg or HCV. Able to give consent EXCLUSION CRITERIA: Patients: Antibiotic therapy for the current episode of Lyme disease Oral corticosteroids within the past 2 weeks History of severe skin disease (such as psoriasis, atopic dermatitis) in the last year. Diagnosis of diabetes, active cancer, or autoimmune diseases. Investigational drugs in the past month History of forming large thick scars after skin injuries or surgery History of excessive bleeding after cuts or procedures or on anticoagulation. Use of steroid cream/ointment at the rash. Healthy Volunteers: History of Lyme disease, or serological evidence for Lyme disease No oral corticosteroids within the past 2 weeks History of severe skin disease (such as psoriasis, atopic dermatitis) in the last year. Diagnosis of diabetes, cancer, autoimmune diseases. Investigational drugs in the past month History of forming large thick scars after skin injuries or surgery No history of excessive bleeding after cuts or procedures or on anticoagulation.