Prurigo Pigmentosa Literature Review Part 4 – Associated with Lyme Disease?

PP Borrelia

Prurigo Pigmentosa Literature Review Part 4 – Associated with Lyme Disease?

Here are links to the prior installments of this series:

I was very excited by the title of this article, especially since it offered potential insight as to a specific infectious etiology to this rash!

This was published in the International Journal of Infectious Diseases, August 2013.  This is a free article, so please feel free to read the whole thing yourself from the link provided.

Molecular detection and genetic identification of Borrelia garinii and Borrelia afzelii from patients presenting with a rare skin manifestation of prurigo pigmentosa in Taiwan

The two organisms in the title, Borrelia garinii and Borrelia afzelii are spiral shaped bacteria that are associated with Lyme disease (LD).

This research group decided to approach the potential causes of this rash from a new angle:

The chronic and recurrent nature of PP is quite similar to the skin manifestations of LD infection, and together with the seasonal prevalence and effective treatment of both of these disorders with doxycyline, this may imply a possible correlation between PP and LD infection.

I thought this was a very refreshing and ‘out of the box’ way to look at this and want to applaud their efforts!

They found 14 cases of suspected PP, and skin biopsies were performed and analyzed for the bacterial DNA while blood samples were obtained to detect LD infections.

In skin specimens, they were able to isolate genetic material from Borrelia spirochetes in 3 of the 14 subjects, and the blood tests from these same individuals demonstrated a Lyme Disease infection.

This group had some interesting observations on the potential relationship between PP and LD:

It is interesting that the skin lesions of PP share some clinical and histopathological characteristics with acrodermatitis chronica atrophicans (ACA), which is a late cutaneous manifestation associated with LD infection.

The possible association of Borrelia spirochetes in the pathogenesis of ACA has been assumed by the isolation of Borrelia spirochetes from patients with ACA.  In the present study, Borrelia spirochetes were isolated from skin specimens of patients with PP skin lesions and Borrelia species was also verified by a nested PCR targeting the 5S-23S intergenic spacer amplicon gene of B. Burgdorferi sensu lato.  These results suggest that Borrelia spirochetes may play a role in the pathogenesis of PP in Taiwan.

After reading through the paper it does raise some interesting questions about a possible infectious cause for PP.  Unfortunately this paper didn’t identify whether any of the subjects had been fasting or dieting prior to the onset of the rash.

The fact that the bacteria were found in only 3 out of 14 subjects doesn’t really say much either.  If they had found it in 14 out of 14, then of course it would be convincing evidence that this particular strain of bacteria is the primary cause… but since they didn’t, the most we can conclude is that there may or may not be a relationship… which isn’t of much help to us at this point.

It could simply have been coincidence that these 3 subjects also had a lyme disease infection on top of whatever was going on already…

In any case, it does at least bear mentioning that if you suspect you have the PP rash and are demonstrating any of the following symptoms associated with Lyme Disease then you should at least get yourself checked out by your physician!

For everyone else, myself included, who can make this rash predictably come and go simply by varying carb consumption, I don’t think this helps us out.

 

 

 

7 Responses to Prurigo Pigmentosa Literature Review Part 4 – Associated with Lyme Disease?

  1. Betsy says:

    Thought this was very interesting. I had late disseminated Lyme Disease, and I used to get a rash on my left outer thigh. The doctor who successfully treated my Lyme Disease (third time in treatment) also had me use a “modified Atkins” style diet. I was supposed to eat primarily protein, fats, vegetables with very small amounts of rice, potato or pasta. Lyme Disease tends to feed on sugars, so no sugars, no processed grains (like bread), etc. It may be something to consider when getting the rash, then being able to get rid of the rash. Carbs (sugars) feeding bacteria may initiate the rash response? Maybe even trying carbs that are NOT those type of sugars would be an option on a carb nite. I’m doing CNS now, myself.

    • BJJ Caveman says:

      How have you found CNS working out for you so far?

      • Betsy says:

        So far, my energy has increased and I’ve dropped a couple of pounds. Mainly, my clothes are fitting better. I first tried Carb Backloading which got me off using Melatonin and a supplement I used to calm my mind for the Melatonin to work better. I stalled and started to feel like I was getting too many carbs, so I switched to CNS. I really think I function better overall on CNS right now. My Dr. had been tracking my labs; and on CBL my cholesterol went up slightly and so did my A1C, and my immune function wa still low. So I’m focusing on those. I also heard Kiefer’s podcast with Dr. Mark Gordon about testosterone; so I asked my Dr. about it since he once before suggested I might try to supplement it, and my regular and free testosterone is still low and hardly budges on DHEA. It should improve all the negative things showing up in my bloodwork. I’ll have more bloodwork soon. My Dr. had been to several of Dr. Gordon’s lectures and has met him. He believes in what Dr. Gordon is doing. So I just started that, too. My weight loss has stalled since I started the testosterone, but I think it’s muscle weight as I can now feel my muscles working much better when weight training! My clothes are still fitting better and I’m looking leaner, so I’m not worried yet. I’m also feeling stronger and can push more weight. So with that getting in balance and being on CNS, I’m looking forward to even better results. I do notice some muscle cramping on my carb nites. I’ve only had 3 so far. This last one, I made sure to eat a banana; and the cramps weren’t nearly as bad. I may have to up it to 2 bananas. One major thing for me is I had breast cancer and now have lymphedema in both arms as a result of having lymph nodes removed. I’m not supposed to eat more than 1,500 mg of sodium per day to help prevent swelling in my arms. That said, I’ve noticed on CNS that the amount of sodium I’m getting is much higher; but I’ve had no swelling and my arms have actually gotten smaller. My clothes show it, but I can also see the change. I read about ketosis that once in that state, you lose sodium more quickly. I’d guess that’s why the extra sodium isn’t an issue. I couldn’t be happier about that! 🙂

        • BJJ Caveman says:

          Wow… thank you so much for sharing your story. It seems like you’ve been through quite a lot! I’m really glad that you’ve found something that is working for you so far. The fact that your clothes are fitting better is fantastic and really shows that you’re moving in the right direction.

          Regarding the cramping, one thing to think about is magnesium supplementation. A lot of the stuff I’ve been reading has pointed to the fact that it’s actually magnesium deficiency that’s related to cramping rather than potassium.

          • Betsy says:

            Yes, I considered magnesium; but I already supplement with magnesium both a.m. and p.m., 400 mg. each. So I could try to increase it some. However, I read back through the CNS book; and he does address cramping on carb nites and says increase water and eat bananas, yogurt or drink fat-free milk. So I may throw in a yogurt with my banana next time, or just go for 2 bananas. On a positive note, it also means that my muscles are definitely sorting the carbs! Lol! It’s kind of an odd nicety when you can actually feel your body doing something it’s supposed to!

            Yes, I’ve been through a lot; but it makes me extremely conscious of what’s going on with my body. Unfortunately, I used to live in the high carb / low fat way of eating for much of my adult life as that’s what we were taught when I went through training (many years ago) to teach aerobics (at a major fitness facility). I taught for 11 years and only quit because of the IV I had in my arm for 6 weeks to treat the Lyme Disease. That was the second treatment, and not the one that finally worked for me. The third one that worked was 15 months of treatment, of those with daily intramuscular injections. It’s an ugly disease! I’m blessed to have finally found a doctor who knew how to treat!

            I’ll have to comment again after I get through my next carb nite to let you know how it goes with the muscle cramps!

          • BJJ Caveman says:

            The other thing I wanted to add is have you checked what type of magnesium you’re taking

            Magnesium glycinate and magnesium citrate are the most absorbable forms of it, so that may also be something to look into.

            Keep us updated!

  2. Betsy says:

    Good point. I was on magnesium citrate; and last time I bought magnesium, I ended up getting magnesium oxide. So I do need to chance back to the magnesium citrate. Thanks!

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