LONDON — Borrelia burgdorferi from tick bites, the causative agent of Lyme disease in the United States, has been linked to cases of primary cutaneous B-cell lymphoma in certain areas of Europe, reported Rein Willemze, M.D.
“It is common dermatologic knowledge in Europe that B. burgdorferi infections can cause reactive B-cell proliferations in the skin,” Dr. Willemze said at the 14th Congress of the European Academy of Dermatology and Venereology. The lesions typically are located on the ear lobes and nipples, which are sites that attract ticks, and most often are marginal zone lymphomas.
Primary cutaneous marginal zone B-cell lymphomas are low-grade malignancies characterized by clonal proliferation of small neoplastic B cells with a Bcl-2+, Bcl-6-, CD10- phenotype, said Dr. Willemze of Leiden (the Netherlands) University Medical Center.
B. burgdorferi-associated cutaneous lymphomas have been reported in Austria and Scotland, though not in Asia or North America. “The most likely explanation is that different subspecies of B. burgdorferi are present in these parts of the world,” he said.
Systemic antibiotics, usually penicillin, cephalosporins, or tetracyclines, may be curative if lymphoma is associated with Borrelia infection, although the optimal regimen has not been established, said Dr. Willemze, who is in the Dutch Cutaneous Lymphoma Working Group.
The relationship between low-grade B-cell lymphomas and bacterial infections is not restricted to the skin. More recognized is the relationship between gastric mucosa-associated lymphoid tissue (MALT) lymphomas, which are similar to primary cutaneous B-cell lymphomas in the skin, and Helicobacter pylori infections.