Can Telemedicine Diagnose Lyme Disease Earlier and Prevent Complications?
Telemedicine improved access to Lyme disease care
Earlier diagnosis led to faster treatment
Patients had fewer neurologic complications
The study, entitled “The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era,” compares clinical data of 439 patients with an erythema migrans (EM) rash before and after the onset of the COVID-19 pandemic.1 Participants in the study were treated at an Italian Dermatology Clinic.
Most individuals with an EM rash were diagnosed using an in-person evaluation before the pandemic and through telemedicine after the onset of the pandemic.
Because erythema migrans is often diagnosed clinically, telemedicine may allow experienced physicians to recognize Lyme disease before neurologic or joint complications develop.
Telemedicine Led to Earlier Lyme Disease Treatment
The number of individuals with an EM rash who were treated within 2 months improved from 35% before the pandemic to 85% after the pandemic.
The findings suggest that telemedicine may help shorten delays between the appearance of an erythema migrans rash and antibiotic treatment.
Telemedicine Improved Access to Lyme Disease Care
The clinic was able to provide consultations for patients living far from the consultation center, including individuals residing in areas considered non-endemic for Lyme disease.
“While during the COVID pandemic a significantly higher rate of patients who resided far from the consultation center were able to receive a virtual consultation and be included in the study thanks to telemedicine.”
The clinic was also able to provide long-distance advice to children with skin lesions.
“Our results are in line with other authors highlighting that during COVID lockdown telemedicine proved to be an effective way to provide long distance advice regarding skin lesions in children.”
Three pregnant women received prompt treatment during the pandemic.
“They were treated with amoxicillin within 1–2 months from the EM onset … the treatment prevented any complication to the babies who were born healthy.”
Fewer Neurologic Complications After Earlier Treatment
The rate of neurologic symptoms, except for headaches, was lower among individuals evaluated after the onset of the pandemic.
The authors suggested that earlier Lyme disease treatment and improved access to care may have reduced the rate of neurologic complications.
“The number of these patients was significantly higher in the in-person consultation group,” possibly as a consequence of diagnosis and treatment delays.
These findings support the importance of recognizing Lyme disease early and reducing barriers to treatment. Learn more about neurologic Lyme disease and the impact of delayed diagnosis.
Can Telemedicine Help Diagnose Lyme Disease?
According to the authors, telemedicine may be especially useful when an erythema migrans rash is present and can be evaluated remotely.
“Our data clearly show that the use of telemedicine for EM diagnosis is helpful as it allows shorter delays in antibiotic therapy and consequently fewer neurological and articular complications.”
The authors concluded that telemedicine could be adopted by both Lyme disease specialty centers and general practitioners to improve access to care.
Frequently Asked Questions
Can telemedicine diagnose Lyme disease?
Telemedicine may help diagnose Lyme disease when an erythema migrans rash is present and can be evaluated remotely by an experienced clinician.
Can a doctor diagnose Lyme disease from a rash photo?
In some cases, an erythema migrans rash can be recognized through photographs or video consultations, allowing earlier treatment decisions.
Does earlier Lyme disease treatment reduce complications?
This study found that earlier treatment was associated with fewer neurologic and joint complications.
Can telemedicine improve access to Lyme disease care?
Yes. Telemedicine allowed patients living farther from the clinic to receive evaluations and treatment recommendations more quickly.
What is erythema migrans?
Erythema migrans is the characteristic Lyme disease rash that typically expands over time. Although some patients develop a classic bull’s-eye appearance, many rashes are atypical and can be mistaken for other skin conditions.
Clinical Perspective
Telemedicine may offer an important opportunity to identify erythema migrans earlier, particularly for patients who live far from Lyme disease specialists. Earlier recognition of Lyme disease can shorten treatment delays and may reduce the risk of neurologic and joint complications.
Clinical Takeaway
Telemedicine improved access to care, shortened treatment delays, and was associated with fewer neurologic complications in patients with erythema migrans. These findings highlight the value of early Lyme disease recognition, whether through in-person visits or remote evaluation.
Related Articles
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Find a Lyme doctor using telemedicine
COVID-19 leads to delayed diagnosis of Lyme disease
Lyme rash misdiagnosis: the bull’s-eye rash is often missed
References
- Trevisan G, Nan K, di Meo N, Bonin S. The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era. Pathogens. 2022;11(10). doi:10.3390/pathogens11101122.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
I live in Los Angeles California. I would appreciate a recommendation for a local doctor for a second opinion. I have been diagnosed with Lyme disease with testing being performed at Vibrant Labs. Thank you.
I advise my patients to check with their doctor or contact LymeDisease.org for names.
Does Dr. Daniel do tele medicine appointments?
You should contact my office with your questions