Clinical update

Updated Lyme disease guidance: what nurses need to know

NICE guidelines say erythema migrans rash should prompt diagnosis without a blood test
Picture of leg with erythema migrans rash

NICE guidelines say those with erythema migrans skin rash should be diagnosed with Lyme disease without a blood test

Essential info

Erythema migrans is a skin rash associated specifically with Lyme disease and is present in approximately two thirds of all cases. Often described as looking like a ‘bullseye’, it is a spreading red rash that usually appears one to four weeks following a bite by an infected tick.

Those who spend a lot of time in grassy or wooded areas are at increased risk of exposure. Infection is more likely if the tick is attached for more than 24 hours. The south of England and Scotland have higher incidence rates. Worldwide, infected ticks are mainly found in the northern hemisphere.

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