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array:23 [ "pii" => "S2387020621002242" "issn" => "23870206" "doi" => "10.1016/j.medcle.2020.05.033" "estado" => "S300" "fechaPublicacion" => "2021-06-11" "aid" => "5318" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2021;156:586-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775320304851" "issn" => "00257753" "doi" => "10.1016/j.medcli.2020.05.033" "estado" => "S300" "fechaPublicacion" => "2021-06-11" "aid" => "5318" "copyright" => "Elsevier España, S.L.U." 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"documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2021;156:585" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Agminated cutaneous metastases of urologic origin" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "585" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis cutáneas agminadas de origen urológico" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 897 "Ancho" => 1667 "Tamanyo" => 329923 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jose Castiñeiras González, Claudia Olmos Nieva, Manuel Ángel Rodríguez Prieto" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Jose" "apellidos" => "Castiñeiras González" ] 1 => array:2 [ "nombre" => "Claudia" "apellidos" => "Olmos Nieva" ] 2 => array:2 [ "nombre" => "Manuel Ángel" "apellidos" => "Rodríguez Prieto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775320304905" "doi" => "10.1016/j.medcli.2020.05.037" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320304905?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621002254?idApp=UINPBA00004N" "url" => "/23870206/0000015600000011/v1_202106060546/S2387020621002254/v1_202106060546/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Chronic erythema migrans" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "586" "paginaFinal" => "587" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Jose Castiñeiras González, Eduardo Varas Meis, Manuel Ángel Rodríguez Prieto" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Jose" "apellidos" => "Castiñeiras González" "email" => array:1 [ 0 => "jcastigon@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Eduardo" "apellidos" => "Varas Meis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Manuel Ángel" "apellidos" => "Rodríguez Prieto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Complejo Asistencial Universitario de León, León, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Policlínica Nuestra Señora del Rosario, Ibiza, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eritema crónico migrans" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1511 "Ancho" => 750 "Tamanyo" => 135162 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">35-year-old male, farmer, with no relevant history. Patient who presents with a 10-day history of asymptomatic erythematous skin lesion of centrifugal growth on the right thigh. He did not report fever or general symptoms and denied a history of bites. On examination, an oval macular lesion was observed on the anterior aspect of the right thigh, annular in shape, with a slightly raised erythematous border of an intense red colour and with clearer demarcation limits in the perilesional skin compared to the centre of the lesion (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No pathological lymphadenopathies were palpated. Lab tests showed a subtle elevation of protein <span class="elsevierStyleSmallCaps">C</span> reactive values. With a clinical diagnosis of suspected erythema chronicum migrans, treatment was started with doxycycline 200 mg per day for 14 days. In addition, <span class="elsevierStyleItalic">Borrelia burgdorferi</span> serologies were performed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">After 10 days, the primary lesion had resolved (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), obtaining serological confirmation, with elevated IgM and negative IgG.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Even in low endemicity areas, we must not forget to include Lyme borreliosis in the differential diagnosis of annular lesions. Patients often do not remember the history of the <span class="elsevierStyleItalic">Ixodes</span> tick bite due to its small size.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">This article has not received any type of funding.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interests" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Castiñeiras González J, Varas Meis E, Rodríguez Prieto MÁ. Eritema crónico migrans. 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