Last reviewed dd mmm yyyy. Last edited dd mmm yyyy
Multiple secondary lesions develop in about 50% of patients several days after the initial lesion. These secondary lesions are usually smaller, not associated with previous tick bites, and do not have an indurated centre. Thought to be due to hematogenous dissemination of the infection from the primary site (1).
Additional dermatologic manifestations may also develop, for example, a malar rash.
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