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what is a em rash?

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Old 11-22-2005, 06:52 PM   #1
Join Date: Nov 2005
Posts: 62
expat64 HB User
what is a em rash?

Forgive my uneducated questions, i am currently being treated with pain meds for fibro for 2 years, and brain mri suggests MS, so i'm doing a million of tests with Neuro now to see if i have MS, or maybe I have never had fibro only MS, or...that I have both. Now, my conern is maybe it's lyme, 2 weeks ago I have developed this weird rash on my left leg. for months my left heel on my foot hurts, behind and to the side of my heel by the ankle, it's so painful, it wakes me up at night, it's burning red in a spot about the size of a silver dollar and red and hot and i get like electrical pain in it, is the only way to describe it, maybe neuralgia, who knows but my leg is turning red and has brown and red splotches......when i was 20 i was hospitalized with toxic shock syndorome, they believed it was because i had a rash all over me andi was sick, it seems to be coming back, and my GP is convinced it's lyme and not fibro or MS. But my neuro thinks GP is nuts, GP is a researcher and has been published with his MS findings showing it's not MS but lyme and he thins I have that. So, what does this rash look like??? and with lyme do you get painful legs. i get horrible cramps that wake me up and my legs seem to lock in the position i was laying in when this cramp starts, i think it's a contracture vs a cramp. i'm at a loss and hope nuro knows about lyme when i ask him tomooro w at my appt. i was tested 2 years ago but test was ng for lime. but from what i've read on this site, that could be normal?? so, i want to do the tests from that special lab and i'm hoping insurance will cover it, i get out of network benefits where i pay 20% if not.
what does rash look like and does it cause bad leg pain and cramps? i don't want an MS diangnosis if it's lime. can anybody help this newbie here and show me theropes on what I should do? I need pain meds daily, ws wearing duragesic pain patch for 1.5 years but it stopped working like all opiates do eventually and they gave me a higher dose patch which made my heart give me irregular heart beats so they took me off and just 4 days ago switched me to oxycontin which helps, but not 100%. I am hoping that by some miracle, docs can find out what's wrong with me and it's not MS and can cure me so i can stop taking pain meds daily. I want my life back!! does the em rash hurt? i hope it's not neurophathy i'm afraaid of gangerene and i had a dibetis test a year ago and it was bordeline but still too low to dx with it. I feel blessed to have such a great pain managment clinic and doctor who believes all pain is pain regarless of it being cancer, fi bro, ms or arthritis, etc etc...........but i can't live like this, chained to a bottle of pain pills that i have to take everyday. and don't bother with any alternative pain methids because i tried them all for 2 years before going to pain managment. I hope nobody takes offense to that, but they don't take a level 9 pain away no matter how much yoga or herbs or accupuncture I do. thank you. this not knowing i the worst. it's probably fibro, but i refuse to accept that dx, i feel like i'm dying and fibro is a effect of something else really wrong with me.
thanks for listening.

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Old 11-22-2005, 06:54 PM   #2
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earle HB User
Re: what is a em rash?

i hope this helps. Mine, however, did not expand.

Erythema migrans — EM is a distinctive raised red skin lesion that occurs at the site of the tick bite. The lesion is usually a salmon colored red and spreads; the redness may be uniform or have a central clearing. In some cases the rash consists of multiple concentric rings, which give it a "bull's eye" appearance (show picture 2). Approximately 90 percent of patients with Lyme disease will develop this lesion although only about 30 percent actually recall having a tick bite. EM usually appears within a week or so (as long as one month) of the bite and lasts several days to several weeks.
The EM lesion occurs at the site of the tick bite, which is most commonly located in the armpit, groin, backs of the knees, or belt line. It usually causes no symptoms but may occasionally itch or burn. EM typically expands outward over several days. Most patients have a single lesion, but about 10 percent have multiple lesions. This pattern is caused by the spread of the bacteria in the bloodstream rather than multiple bites.
EM may be confused with a mild, transient redness at the site of the tick bite that typically lasts for 24 to 48 hours. This redness is due to a reaction caused by tick saliva and not to Lyme disease; occasional patients have an allergy to tick saliva. On rare occasions this kind of redness can last for up to a week. The way to tell this is not due to Lyme disease is that the rash does not expand and typically gets less red. Were it to be erythema migrans, the rash would expand and remain red, often getting more intensely red. When in doubt, a doctor should be consulted. The doctor can help distinguish between this simple redness, which does not require treatment, and EM, which does require treatment.

Old 11-23-2005, 10:37 AM   #3
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Location: Delmarva area
Posts: 728
Re: what is a em rash?


Interesting to note, in the largest Lyme study to date, which was the Lyme vaccine trials (Glaxo SmithKline), it was found that a diffuse blotchy appearing rash was the most common EM, not the "bullseye". Only 60% of patients developed any rash at all.

An EM can take on numerous appearances and shapes. It can be raised or not, it can be hot and/or itchy or it may not be, it may be circular or it may appear as a line or it may be some other shape altogether. Multiple EM's can occur if the bacteria migrate to other sites. Also good to be aware that on darker skintones the EM can be mistaken for a bruise.

Last edited by TINUVIEL; 11-23-2005 at 10:40 AM.

Old 11-23-2005, 05:14 PM   #4
battling on
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battling on HB User
Re: what is a em rash?

Originally Posted by TINUVIEL

or it may not be, it may be circular or it may appear as a line or it may be some other shape altogether.
Wow!! as the only dought i had about the rash on the back of my leg was it ended in a straight line, i thought i had slept on a cushion funny and it was a pressure mark, but no white lines showed when i rubbed my hand over it. i think it went in 2 days.

But the bite which also swelled was on my back and at waiste line.

Thanks for that info, everyday something new.

Last edited by battling on; 11-23-2005 at 05:15 PM.

Old 11-23-2005, 10:09 PM   #5
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Join Date: Feb 2005
Location: Delmarva area
Posts: 728
Re: what is a em rash?


There is an excellent picture of this type of long, thin, "straight line" EM in Karen Vanderhoof-Forschner's book.

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