A Prospective Study to Characterize Symptoms and Symptom Severity in Adult Patients with Extracutaneous Manifestations of Lyme Disease: Extracutaneous Lyme Disease.

Lyme disease patients with ECLD had a similar frequency of symptoms at baseline compared to patients with erythema migrans . ECLD subjects, however, were significantly less like to be Caucasian raising the question of whether a preceding erythema migrans skin lesion may have been missed in persons with a darker skin color. An important limitation of our study, however, is that we did not record skin color per se, which should be considered for future studies.