Erythema migrans (IMAGE) Elsevier Caption Erythema migrans (EM) is classically described as a flat, blanchable, annular, erythematous skin lesion with or without central clearing, occurring at the site of Borrelia burgdorferi inoculation. The rash typically develops 3 to 30 days after exposure and can reach up to 30 cm in diameter (A and B). Atypical presentations include vesicular lesions (C), confluent erythematous lesions (D), urticarial lesions, transient EM, and disseminated EM (E), itself a feature of disseminated Lyme disease. EM may be easily misdiagnosed in patients with darker skin (F). Credit Centers for Disease Control and Prevention. Lyme disease. https://www.cdc.gov/lyme/index.html [public domain] Usage Restrictions No restrictions. License Public Domain Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.